In an attempt to help our office make sure tasks are done for every appointment, I am going to add a checklist or flow sheet in the end for appointments.
To start with, a simple customizable checklist is what I have in mind. The checklist could be customized in the definitions section.
I have a big vision to extend this to customizable "flow sheet" that shows in one window the basics you should know about all patients at each appt:
a) Prep work
1) Finances worked out
2) Tx plan entered in computer
3) Prep lab work done (custom trays, etc)
b) During Appt
1)What was done today,$ today, account $,
2)Financial Arrangement made
3)What is next/planned appt
4)What referrals are needed
5)Pre-Est Needed
6)Special instructions for front desk
7)Lab Case needed
c) Follow Up
1)Care Call to pt done
2)Thank you letters sent
3)Pre-est sent
4)Lab case sent & case in computer attached to appt
5)All Ins sent
6)All notes entered
How all this would work, at the moment I don't know, but any input would be appreciated!
Checklist/Flow sheet for appts
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jordansparks
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I have a few comments.
1. It will be highly variable between offices. Care must be taken to keep it very customizable.
2. You seem to be formalizing business rules. They seem to be the kinds of rules that most offices don't ever formalize, but instead rely on word of mouth and experienced employees to implement.
3. Version one looks like it could be done without any automation at all. In other words, it could just as easily be done on paper.
4. Many offices that do have experienced staff would find it to be more of a burden to check off the lists... unless it was automated.
5. The real power of such a list would be if it were automated; if things were checked off automatically. Even experienced users would find value in it then, because they would begin to use it as a way to keep from forgetting something. That's something that computers are much better at than humans.
6. Queries could probably be written for many of your items which would let the system "deduce" whether the item was done. We could write most of these queries, and users could be allowed to write their own queries for extra things that they wanted to automate. The queries could be triggered each time you open the checklist. The queries would go through each of the unchecked items and check them if it thinks it was done. The user could also manually check some items.
The database tables might look like this:
flowsheet table for each flowsheet.
flowsheetitem table stores the items for a flowsheet in progress or saved.
flowsheetdef table stores the template flowsheets, maybe has just one row.
flowsheetitemdef table stores items that are attached to the templates.
The reason for the two "def" tables is so that when you start a flowsheet on a patient, it makes a copy of the template. This would allow you to change the templates at any time without damaging patient data. The two "item" tables would store the queries, too.
7. I really don't want to have another row type in the Progress Notes to deal with, so instead of a "flowsheet" table, perhaps would could attach the items directly to an appointment. We will be attaching more things to appointments in the future anyway, such as progress notes that apply to all procedures. So attaching them to the appointment directly would seem to make the most sense.
8. Dentrix had a very low-tech version of checkoff lists on their appointments which was really just useful to keep track of the status of the appointment. It was hardcoded directly to the definition table, causing all sorts of problems.
9. I can make space for it on the appointment edit window. I'm getting tired anyway of the way the two lower grids fight for space, so it needs to be revisited.
1. It will be highly variable between offices. Care must be taken to keep it very customizable.
2. You seem to be formalizing business rules. They seem to be the kinds of rules that most offices don't ever formalize, but instead rely on word of mouth and experienced employees to implement.
3. Version one looks like it could be done without any automation at all. In other words, it could just as easily be done on paper.
4. Many offices that do have experienced staff would find it to be more of a burden to check off the lists... unless it was automated.
5. The real power of such a list would be if it were automated; if things were checked off automatically. Even experienced users would find value in it then, because they would begin to use it as a way to keep from forgetting something. That's something that computers are much better at than humans.
6. Queries could probably be written for many of your items which would let the system "deduce" whether the item was done. We could write most of these queries, and users could be allowed to write their own queries for extra things that they wanted to automate. The queries could be triggered each time you open the checklist. The queries would go through each of the unchecked items and check them if it thinks it was done. The user could also manually check some items.
The database tables might look like this:
flowsheet table for each flowsheet.
flowsheetitem table stores the items for a flowsheet in progress or saved.
flowsheetdef table stores the template flowsheets, maybe has just one row.
flowsheetitemdef table stores items that are attached to the templates.
The reason for the two "def" tables is so that when you start a flowsheet on a patient, it makes a copy of the template. This would allow you to change the templates at any time without damaging patient data. The two "item" tables would store the queries, too.
7. I really don't want to have another row type in the Progress Notes to deal with, so instead of a "flowsheet" table, perhaps would could attach the items directly to an appointment. We will be attaching more things to appointments in the future anyway, such as progress notes that apply to all procedures. So attaching them to the appointment directly would seem to make the most sense.
8. Dentrix had a very low-tech version of checkoff lists on their appointments which was really just useful to keep track of the status of the appointment. It was hardcoded directly to the definition table, causing all sorts of problems.
9. I can make space for it on the appointment edit window. I'm getting tired anyway of the way the two lower grids fight for space, so it needs to be revisited.
Jordan Sparks, DMD
http://www.opendental.com
http://www.opendental.com
I like your ideas very much about automation of this type of thing. That's the only way it would be truly useful and not just more trouble.
If we could put it on the appointment, I think that is the perfect place.
Also i think a central indicator somehow like the lab cases on the appt book to show things not done. Although I could see this could be getting very involved. (but what project isn't?)
I might start working on this sometime soon...although finding the time could be challenging :p A rough framework like you laid out is very helpful.
If we could put it on the appointment, I think that is the perfect place.
Also i think a central indicator somehow like the lab cases on the appt book to show things not done. Although I could see this could be getting very involved. (but what project isn't?)
I might start working on this sometime soon...although finding the time could be challenging :p A rough framework like you laid out is very helpful.
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jordansparks
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As I've thought about it some more, I was able to get it down to just two tables. I also shortened their names:
flowitem table stores the items for each patient. FK to appointment.
flowitemdef table stores the default list. No foreign keys at all.
As for showing it on an appointment, how about something that looks like a progress bar? Let's say it has 20 ticks that each turn bright green as the flowitem get completed. You could tell at a glance the approximate number of flowitems that had been completed without having to know specifically which ones.
I enjoy thinking about the technicality of implementing it, but I do have to say that I don't personally consider this to a much of a priority.
flowitem table stores the items for each patient. FK to appointment.
flowitemdef table stores the default list. No foreign keys at all.
As for showing it on an appointment, how about something that looks like a progress bar? Let's say it has 20 ticks that each turn bright green as the flowitem get completed. You could tell at a glance the approximate number of flowitems that had been completed without having to know specifically which ones.
I enjoy thinking about the technicality of implementing it, but I do have to say that I don't personally consider this to a much of a priority.
Jordan Sparks, DMD
http://www.opendental.com
http://www.opendental.com
The progress bar sounds like a good idea and then you could click the bar to see the specifics.
I realize it is not a priority as you have many other items on the agenda, but am just trying to get an idea on how to do it and then maybe I can start work on it.
My vision is for this to really help out to: 1)Make sure things don't fall through the cracks & 2)Help communicate everything between front and back
To accomplish this there needs to be an indicator for future appts for things that need to be done. and then a way to check past appointments and make sure everything was followed through. Like the ! on appt now, except extended to cover other items. And if you placed your mouse over it could give you feedback on what needed to be done.
That way you can see at a glance what pts need attention.
I realize it is not a priority as you have many other items on the agenda, but am just trying to get an idea on how to do it and then maybe I can start work on it.
My vision is for this to really help out to: 1)Make sure things don't fall through the cracks & 2)Help communicate everything between front and back
To accomplish this there needs to be an indicator for future appts for things that need to be done. and then a way to check past appointments and make sure everything was followed through. Like the ! on appt now, except extended to cover other items. And if you placed your mouse over it could give you feedback on what needed to be done.
That way you can see at a glance what pts need attention.
Last edited by drtech on Sat Feb 16, 2008 12:43 pm, edited 1 time in total.
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jordansparks
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- Joined: Sun Jun 17, 2007 3:59 pm
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Storing this data in a flowitem table would make refreshing the appointment module blazing fast no matter how much of this sort of info you wanted to show. You wouldn't have to have a query for every status indicator that worked on the fly. Currently the ! works on the fly, so it's not efficient. So with efficiency solved, the main problem becomes when to synchronize. The good new is that a "synchronize" sequence would not have to run queries for flowitems that were already marked as done. It would only have to evaluate flowitems that were not yet done. A synch sequence could easily run every time an appointment is opened. Also synch could run when the user performs certain actions that would obviously change a status, such as sending a claim. And the synchronize sequence could not do anything for offices that had this feature turned off.
Jordan Sparks, DMD
http://www.opendental.com
http://www.opendental.com