CPRS: clinical self-reminders; team-oriented-checklist

[rrichards]

There is interest in VA for the following features in VISTA/CPRS:

1.  clinical reminder-to-self:  CPRS does not currently have the capability to set  reminders on a given patient for followup of specific lab results or task.  As a  workaround clinicians create a progress note and leave it unsigned, which then appears in their inbox as a crude form of nonspecific reminder.  A better solution would be a capability to set a "reminder to self" for a given task to trigger a reminder for this at a specific date.

2. team-oriented checklist:  For workflows that requires execution of a care pathway involving multiple different care providers, such as perioperative care  (preop,  intraop, postop care for a surgery; or team coordination for complex othopedic / physiogherapy /nursing care) it would be good to have a checklist so that all teams can see the same, single checklist / care pathway and each team sign off on their respective part of the checklist.

Are these features available in some other form in VISTA/CPRS?

If not, what is the complexity of implementing the above features in VISTA/CPRS?

Rafael

[Thurber, Joseph H]

For the reminder to self, we at Central Regional Hospital added a “sticky notes” feature that allows clinicians to write such “notes” to themselves or others.  Not hard to implement but not yet open source.  Stay tuned though!

On Mar 7, 2022, at 5:15 PM, rrichards <rmr...@gmail.com> wrote:



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[rrichards]

Really looking for guidance and framing the problem in correct technical terms rather than a COTS solution.

The solution would be developed by the VA CPRS team and in Delphi and then would be open sourced.

[Thurber, Joseph H]

What we did is in Delphi and in CPRS using the VA’s alert system.  Not much of a stretch for your team I’m sure!

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[Kevin Toppenberg]

In our office, we solved this problem 2 ways:

1) Tickler system:  We drop a TIU Text object into a note, something like this:

======================================

Tickler Entry

Due date:  1/1/1980

Recipient:  Dr. K. Toppenberg

======================================

We use a standard text GUI dialog to pick the date and provide a drop-down of possible recipients.   But part of the generation of this calls the TIU TEXT OBJECT system on the server, and that code makes note of TIU DOCUMENT being edited.  It then schedules a recurring task to check back on the note, waiting for it to be signed.    After it is signed, it scrapes out the date and recipient and stores them off in a Fileman file.  Another scheduled task then checks this file every day.  And when the due date has arrived, it creates an addendum to the note like this:

======================================

Tickler message due date has arrived. 

Please see details of original message.

This note may be edited if needed.

======================================

It then sets the expected signer to be the tickler recipient and it will then show up in their task list.

The advantage of this system is that we can set it for 6, 9, 12 months in the future.  Really any amount of time.  And it will be out-of-sight during all that time.   We have used this system for something like 5-10 yrs and it has been great.  It requires NO CHANGES TO CPRS to get this to work. 

2) A second way to remind oneself to look at labs etc is to be able to recreate the lab alert.  Thus if I look at a low hemoglobin value and want to be reminded to look at it again at the end of the day, I can right click and choose our custom "send lab alert" menu option.  I can send it to myself, or to someone else if needed.    This would be only helpful for things to put off for a day or two.

Kevin T

[Matt King]

Sounds like a nice system!