Delete alternative treatment plans ?

[mzrdmd]

If I work up three different treatment options for a patient, A, B, and C, and the patient chooses to go with B, how do I remove A and C from the chart so that they don't continue to show up as outstanding treatment needs ? Do I have to go through and delete each line item ?

For example, in option A, tooth 8 endo, post, core, and crown. In option B, it needs to be extracted. Patient chooses to have endo, post, core, and crown, which we do and mark complete. However, the chart still shows that it is treatment planned to be extracted. Do I have to go back into their chart and delete the extraction from the treatment plan ?

Also, is there a way to print out treatment plans showing the endo treatment plan without the extraction, and the extraction treatment plan without the endo ?

Thanks,

Mike

[jordansparks]

It's best to discuss it with the patient and make them decide before going to all the bother of printing up both TPs. It should be very rare that you actually add the endo and the extraction to the TP.

To print up just the endo, highlight the procedures before saving the TP. Only procedures that are highlighted will be saved as part of the TP.

[mzrdmd]

I know how to save the different treatment plans, but that is where the problem lies.

I bring new patients in for a comprehensive exam, including FMX, photos, Dx models, perio, etc. It is an extremely comprehensive exam. I then work up different treatment plans for them, including all of their options. I then meet with the patient and present all of the options to them, and let them decide which option they would like to pursue. I would say that the average is 3 or 4 different treatment plans per patient.

In order to do it this way, I NEED to enter all of the options into the different treatment plans so that I can present them, including the financials.

Is there a way to "show" only one of the treatment plans but not the others ?

Thanks,

Mike

[mzrdmd]

Is there a way that I can export the "unwanted" treatment plans to a pocket drive or DVD, then delete them from the program ? Another way I was thinking of doing it would be to scan in the printed treatment plans, then delete them, but it would be much easier to export them.

Also, when I delete the treatment plans, do I have to go back and delete each individual procedure ?

For that matter, if I just delete the procedures but leave the treatment plans in, then I will STILL have a record of them, without scanning them or exporting them, AND the treatment plans that are not selected will NOT show on the chart. That may be the best way to do it, no ?

Still , it would be REALLY NICE if I were able to make the charting show only one treatment plan option at a time. Please let me know if that is possible.


Thanks,

Mike

[Nate]

I often give a number of different options for patients in their treatment plans. Implant rather then Bridge, Composite over Amalgam, Crown rather then large filling, etc.

Simply enter all the treatment in the treatment plan. You can order them by numbers, or add letters and letter the sequence to differentiate between the plans. Once all the different treatment options are entered then highlight all the ones that would be one option and save treatment plan. You can even name the treatment plan bridge. Then highlight all the ones that would be a different option and save as a different treatment plan (implant). When you print your SAVED TREATMENT PLANS, they will only show that option on the chart, not all the work you entered into the chart.

As far as after selecting an option I disregard all the other info. I usually delete the treatment from the chart that the patient does not want and do what they do. I think the record would be recorded in the saved treatment plan.

[jordansparks]

Well, I really had no idea that there was much demand for this feature. Maybe it's just because I like to move at a faster clip with my patients. Honestly, I think such decisions are much better made with an oral discussion that precedes the creation of a formal TP. However, I understand that everyone has a different style, so this will certainly become part of the TP module the next time we overhaul it.

For those who are interested in the technical implementation, I think it will go something like this: The existing tables will continue to be used. In addition, users will be able to set the order of the saved treatment plans so that it's easy to see which one is first/accepted. Also, users will be allowed to add/remove procedures from saved TPs. Finally, we'll make it so you can see procedures for just one TP on the graphical chart.

[parksjdp]

I know that we have many instances when we need to create multiple treatment plan options. Its not that we don't have a good idea of what we want them to do, it is the patients that want to see all the options and then take them home to go over and discuss with spouse. For example, today we had 6 instances in which the patients wanted all options to take home and discuss. We have been able to get by just by selecting procedures and saving multiple trt. plans then selecting the one that they decided on.

[jordansparks]

We don't tolerate wishy washy. We make the indecisive ones sit in the chair until they decide. And we will push them in the direction we think they would naturally go. If we see a 20 yo with no job, ragged clothes, and other rotten teeth, we will push them towards the extraction after fully explaining an RCT. We're not going to print up an RCT for someone who can't afford it. It's such a waste of everyone's time when they call to cancel their RCT appointment. One of our favorite lines is, "Well you have to decide now, or I don't know what to put into the computer for your next appointment."

[Jorgebon]

We also try to have the patient decide while in the chair. Nevertheless, there are options like using clinical notes or tooth notes for special cases. It's also good to have it all documented in a narrative. If someone else reads the progress notes, it's better to have a note stating what you explained alternatives to the patient rather than having a treatment plan saved in another part of the program. Then when the patient decides, you can enter the accepted treatment plan in the chart. What I really think we still need is a way to mark treatment plans that were abandoned by the patient or declined after it was already in the chart. For example, a patient procrastinates and a caries gets to be too deep for a regular filling and now he needs a root canal, build up and crown instead of the original filling we had in the tx plan. I don't want to delete that filling from the treatment plan because I want evidence that we had diagnosed that caries and that it was the patient's fault for not getting it fixed in time. So we should have a category together with "Tx Plan, Complete, Existing Current, Existing Other and Refer" that would mark it as never completed.

[jordansparks]

If you have saved a TP, and then later delete procedures that are shown on that TP, the procedures will certainly remain on the saved TP. Delete TP procedures with confidence. The ones on the saved TPs are copies that will never go away unless you delete the entire TP.

[mzrdmd]

Nate, that's exactly what I have been doing, but when I print one of the saved options, EVERYTHING prints on the graphical chart, which is confusing as hell to ME, let alone to the patient. Is there a setting somewhere that I can change to make the graphical chart show only what that particular treatment plan shows ?

Jordan and Jorge, how do you get your patients to commit to treatment if they don't know how much it will cost, how much their insurance will cover, etc ? One of the things that I like so much about OD is that I have the ability to save multiple TP's........for documentation, as someone else has already said.

Jordan, the upgrade in the future sounds like it will be GREAT ! Thanks again for such an awesome program ! Keep up the good work !

Mike

[DavidWolf]

When the treatment plan module gets revamped, it might be a good time to incorporate the ability to save snapshots of the graphic tooth chart.

Also would be nice to have the total column fixed so treatment plans over $10,000 fit in the column.

[mzrdmd]

It would also be nice to have the "Secondary Insurance" column print/disply only if the patient actually has secondary insurance.

Thanks,

Mike

[Jorgebon]

Mzrdmd,
I can almost always tell the patient what their plan covers and how much they have to pay. We've taken the time to enter fee schedules, copay schedules and allowed fees for practically all the plans we see. So when the patient has all the different options explained I can give them an estimate while I'm still talking with them. With the few patients where I don't know what their plan will cover, I'll go through the alternatives and tell them how much it would cost if they were to pay cash. We don't get many patients like this since most plans in my area will only pay those dentists that have signed contracts with them.

[kderhami]

Hi everyone:

I don't know whether this suggestion is helpful but the way I do it is everytime I have a patient for examination after reading the xrays and clinical examination, I go into the treatment plan module, then in the upper window under "treatmentPlan" I open a new "proposed treatment Plan" ( this is done for recalls as well) then write my findings, proposed treatment plan(s), each needed appointment and suggestions for my patient. If needed I will open a "Heading" for alternative tx-plans and name them seperately, so that I can delete any or none.

Under the "default" I have a template stored that I can use as a generic template with headings such as List of findings, To do list, alternative tx-plans, suggestions. This I use as a template for every examination and almost always only use the graphics under the "Show" window so I can highlight by hand the teeth that need treatment. If by next recall things are the same, I just copy and paste the previous tx-plan to a the date that day.

[mzrdmd]

You have me totally lost.

Where is the upper window under treatment plan ? You're in the window that shows their chart, right ?

Once I figure out where this is, I'll try to follow the rest of what you've described, but I might have more questions.

Thanks,

Mike

Hi everyone:

I don't know whether this suggestion is helpful but the way I do it is everytime I have a patient for examination after reading the xrays and clinical examination, I go into the treatment plan module, then in the upper window under "treatmentPlan" I open a new "proposed treatment Plan" ( this is done for recalls as well) then write my findings, proposed treatment plan(s), each needed appointment and suggestions for my patient. If needed I will open a "Heading" for alternative tx-plans and name them seperately, so that I can delete any or none.

Under the "default" I have a template stored that I can use as a generic template with headings such as List of findings, To do list, alternative tx-plans, suggestions. This I use as a template for every examination and almost always only use the graphics under the "Show" window so I can highlight by hand the teeth that need treatment. If by next recall things are the same, I just copy and paste the previous tx-plan to a the date that day.

[Nate]

Mike,

I don't think you understood how I enter multiple treatment plans and print them because I am able to print them with only the options I want on them and it very simple. I can give the option of implant vs bridge, crown vs large filling or any other options. Let me explain again...

Simply enter all the treatment in the treatment plan. For example if #3 has irreversible pulpitis you could enter endo, BU, Crown. You could also enter extration. Now both would show on your chart and on your main treatment plan. So you highlight the endo,BU,Crown and save it as proposed tx plan. Then you can even change the name if you like 'Proposed treatment plan for saving tooth'. Then you go back to main default treatment plan where you again will find all that you have entered. This time only highlight the extraction and save that proposed treatment plan. Rename this 'Proposed Treatment plan for extraction'. Now you should have the default treatment plan along with 2 others. The default will show all treatment you entered on one chart and be confusing, BUT the individual treatment plans that you renamed will only show what you had highlighted on them along with the title so you and the patient can easily distinguish between them.

When you print your SAVED TREATMENT PLANS, they will only show the option you wanted on the chart, not all the work you entered into the chart.

I think you are printing the default treatment plan and that is why everything is showing up on the chart. Just remember to highlight what you want as an option, then click 'Save TP'. Then when you want to print make sure you first click on the Treatment plan you saved then click the 'Print TP' button.

Does it make since this time? This will allow you include any number of different options and will print out clearly without clutter on the chart.

[mzrdmd]

Thanks for taking the time to type that all out, Nate. I truly appreciate it.

You have described exactly what I have been doing. I have been printing out the different treatment plans, not the default treatment plan. The problem is that the chart that prints on the different treatment plans still has EVERYTHING charted on it. It's as if the default chart prints on every different treatment option.

Also, using your example, if the patient chooses extraction of #3, the chart will still show endo/BU/crown for #3. This is the crux of the situation. When we are trying to schedule patinets for their next appointment, we don't know WHAT still needs to be done, because everything is still on the chart, AND there is no way to mark which option the patient has chosen, so we don't know if we should be going to the next appointment in the extraction option or the endo option.

I think I am just going to go back and delete the procedures from the chart that are not part of the patient's chosen option. This will remove them from the graphical chart, but they will still be listed in the alternative treatment plans. This will provide documentation that I had given the patient their options, and will also allow me to put things back together if a patient should happen to decide to change course in the middle of their treatment plan.

One thing that would definitely be nice in a future version would be for the office to be able to mark a certain option as the patient's choice, and that would then become "THE" treatment plan, and the other options would then not display unless they were specifically brought up.

Just my 2 cents.

Thanks for the input,

Mike

[Nate]

Mike,

What version are you using?

You have described exactly what I have been doing. I have been printing out the different treatment plans, not the default treatment plan. The problem is that the chart that prints on the different treatment plans still has EVERYTHING charted on it. It's as if the default chart prints on every different treatment option.

Sounds like a bug in your version! I dont believe the default chart should be printing each time. It has never happened to me and I have used many versions in the past. I guess it could be something that has either been changed very recently or a bug.

In my example if the patient chooses extraction of #3, the chart will NOT show endo/BU/crown for #3 when I print it.

[jordansparks]

Oh, yeah. I forgot that we did program it that way. It's smarter than I thought. It should only print graphics for the current TP.

[mzrdmd]

Jordan, any progress to report on making the program do what you talked about below ? I'm currently using version 5.6.14.0.
Another thing I'm looking to do is to be able to export a default TP to a thumb drive that I can take home (over the weekend, for example), break it down into specific options, save those, then be able to import it back into the program on Monday. Any chance of that happening ?

Thanks, you ROCK !!!!

Mike

Well, I really had no idea that there was much demand for this feature. Maybe it's just because I like to move at a faster clip with my patients. Honestly, I think such decisions are much better made with an oral discussion that precedes the creation of a formal TP. However, I understand that everyone has a different style, so this will certainly become part of the TP module the next time we overhaul it.

For those who are interested in the technical implementation, I think it will go something like this: The existing tables will continue to be used. In addition, users will be able to set the order of the saved treatment plans so that it's easy to see which one is first/accepted. Also, users will be allowed to add/remove procedures from saved TPs. Finally, we'll make it so you can see procedures for just one TP on the graphical chart.

[drtech]

just use Logmein.com to one of your computers at the office...this saves a lot of hassle of thumb drive transfers and it is always up to date!

[jordansparks]

I just put it on the future versions page near the top.

[mzrdmd]

just use Logmein.com to one of your computers at the office...this saves a lot of hassle of thumb drive transfers and it is always up to date!

Drtech, I AM using Logmein, but it is too slow for my liking.

Thanks,

Mike

[drtech]

Drtech, I AM using Logmein, but it is too slow for my liking.

Mike,
Well, then that is a good reason to use the thumb drive!...i'm sure you have already tried this, but turn down the quality of the logmein screen and make sure you have at least DSL internet on both ends...then it seems to work at reasonable pace for us...especially for evening "work." It certainly would be too slow for regular use however.

[mzrdmd]

Drtech, I AM using Logmein, but it is too slow for my liking.

Mike,
Well, then that is a good reason to use the thumb drive!...i'm sure you have already tried this, but turn down the quality of the logmein screen and make sure you have at least DSL internet on both ends...then it seems to work at reasonable pace for us...especially for evening "work." It certainly would be too slow for regular use however.

I have cable on both ends, but don't know how to turn down the quality of the logmein screen. Can you tell me how to do this ?

Thanks,

Mike

[parksjdp]

Mike

I think that he means the quality of the screen view. To adjust, you must click on the color quality icon (looks like the microsoft windows icon) and adjust from grayscale to high quality.

[mzrdmd]

Mike

I think that he means the quality of the screen view. To adjust, you must click on the color quality icon (looks like the microsoft windows icon) and adjust from grayscale to high quality.

OK, thanks. Where is it ? By the clock ? And what exactly do the keys on my keyboard with the Windows logo on it do ?

Thanks,

Mike

[parksjdp]

Mike

Sorry for the confusion. You will need to have a logmein session active. Once you have that, at the top right of the logmein screen, you will see some icons with settings for logmein. There will be on that says color quality (looks like windows icon). Here is where you make those changes. You can have it as little as grayscale (fastest) to high quality (slow).

[mzrdmd]

Mike

Sorry for the confusion. You will need to have a logmein session active. Once you have that, at the top right of the logmein screen, you will see some icons with settings for logmein. There will be on that says color quality (looks like windows icon). Here is where you make those changes. You can have it as little as grayscale (fastest) to high quality (slow).

OK, thanks. Actually, I am not sure if I am using logmein or winvnc. My administrator set it up for me. I'll have to check and see, but I don't think I have those buttons.

[parksjdp]

If you are not, it is quite easy to use and set up. I have had good luck with it, even though it is not as fast as one would like, but it is a remote connection. Also, David says there is a way to set the free version up with printing capabilities, even though I have not been able to get it going, not as technical as him.

[steveng]

One more suggestion.
Most of our patients are fee for service and we offer them certain discount on entire TP if they pay upfront.
It would be really useful to be able to make such an adjustment directly from TP module and show this figures on accepted TP statement. Future release?

[parksjdp]

Couldn't you just change the figures on the saved treatment plan to show your discount amounts? You would also have to change the fee in the acutal chart to reflect the discounted price then as well.

Another idea would be to set up a N code that would be for Cash Discount. You could then set up a quick button for it and esentially treatment plan it and assign your discount to it. That way when you print out your TP it shows the cash discount portion on it. I have not tried it though so it may not work exactly how I am picturing it.

[jordansparks]

I'm locking this thread. It's way too long and has at least 3 topics going.