Guest guest Posted May 11, 2009 Report Share Posted May 11, 2009 Wow, I guess I was wrong about EMRs and the impact they can have. My guess is that prior to AC, the ortho doctor could rarely interpret the ramblings of the shoulder, but now the shoulder knows a heck of a lot about the rest of the body. You might want to let him know to reread his notes. J From: [mailto: ] On Behalf Of Jean Antonucci Sent: Monday, May 11, 2009 9:41 AM To: Subject: EMR S I just got a note from an ortho colleague who just got AC THE NOTE SAYS FOR EXAM: " EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT PATIENT A RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT " AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT HEARING VOICES ,AND HAS NO LUMPS If he only knew I read this stuff. -- If you are a patient please allow up to 24 hours for a reply by email/ please note the new email address. Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2009 Report Share Posted May 11, 2009 Oh dear...I just got a note from an ortho colleague who just got AC THE NOTE SAYS FOR EXAM:"EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT PATIENTA RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT "AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT HEARING VOICES ,AND HAS NO LUMPS If he only knew I read this stuff.-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2009 Report Share Posted May 11, 2009 Thanks for the laugh. I had a little girl go to the urologist, and he must have had a new EMR, because the exam showed she had a normal penis…. And the old records of a pt of mine came from her gyne, and it said on her bimanual exam that she had normal tonsils… J Eads, MD Pinnacle Family Medicine Colorado Springs, Colorado www.PinnacleFamilyMedicine.com From: [mailto: ] On Behalf Of Jean Antonucci Sent: Monday, May 11, 2009 7:41 AM To: Subject: EMR S I just got a note from an ortho colleague who just got AC THE NOTE SAYS FOR EXAM: " EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT PATIENT A RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT " AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT HEARING VOICES ,AND HAS NO LUMPS If he only knew I read this stuff. -- If you are a patient please allow up to 24 hours for a reply by email/ please note the new email address. Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2009 Report Share Posted May 11, 2009 Is it the way his system is pattern matching? I mean, he typed in "non tend" or "nt'" and got "non tendered" . Beats the heck out of me how he got "...not hearing voices" Anyone care to guess?I had mine set up for lots of shortcuts "St" meant "sore throat". You know that kind of stuff. It's made for some odd turns of phrases. Example: "applied a sugar tong splint on the left ankle" turned into "applied blood sugar tong to left ankle"I bet we could find some very funny episodes of pattern matching in our emr charts. Wait, wait! We could have IMP parlor games at IMP camp. 'Guess the Pattern Match' Kathleen (always looking for something to smile about.)I just got a note from an ortho colleague who just got AC THE NOTE SAYS FOR EXAM:"EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT PATIENTA RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT "AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT HEARING VOICES ,AND HAS NO LUMPS If he only knew I read this stuff.-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2009 Report Share Posted May 11, 2009 consult request to urology " pt not able to pass urine, please come and pass urine.. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2009 Report Share Posted May 11, 2009 I made the mistake of initially making a macro for " org " to mean organomegaly. Bad Idea Antonucci -->when I send out letters saying please go to howsyourhealth.organomegaly I did not look cool. Is it the way his system is pattern matching? I mean, he typed in " non tend " or " nt' " and got " non tendered " . Beats the heck out of me how he got " ...not hearing voices " Anyone care to guess? I had mine set up for lots of shortcuts " St " meant " sore throat " . You know that kind of stuff. It's made for some odd turns of phrases. Example: " applied a sugar tong splint on the left ankle " turned into " applied blood sugar tong to left ankle " I bet we could find some very funny episodes of pattern matching in our emr charts. Wait, wait! We could have IMP parlor games at IMP camp. 'Guess the Pattern Match' Kathleen (always looking for something to smile about.) I just got a note from an ortho colleague who just got AC THE NOTE SAYS FOR EXAM: " EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT PATIENTA RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT " AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT HEARING VOICES ,AND HAS NO LUMPS If he only knew I read this stuff.-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address. Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org -- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2009 Report Share Posted May 11, 2009 I bet the doc was using voice recognition and does not have the bugs out of it. I have switched to ShortKeys and templates instead of voice dictation. In my first attempt with voice recognition everytime I said "husband" it came out "has been". Recently found a chart from last year- obviously I dictated when I had my young weimaraner, Baxter, in the office with me. If I say "go to sleep" the microphone should mute. My dicatation read: "go to sleep, fax her, out, Baxter NO baxter NO NO out" On a more helpful note, I have improved my accuracy in documentation with templates by having multiple templates for each section of the exam. GYN with pap; GYN w/o pap; GYN hysterectomy. Prior to this, I would try to cut and delete what was not actually done... but particulary on women with hysterectomies, I would not do that step- so it looked like I saw a cervix and did a pap... lots of corrections after the fact which was not pretty. (I use AC). Carla To: Sent: Monday, May 11, 2009 7:40:39 AMSubject: EMR S I just got a note from an ortho colleague who just got AC THE NOTE SAYS FOR EXAM:"EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT PATIENTA RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT "AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT HEARING VOICES ,AND HAS NO LUMPS If he only knew I read this stuff. -- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2009 Report Share Posted May 11, 2009 Good one Jean. That's right up there with shoulders "not hearing voices.": >)KathleenI made the mistake of initially making a macro for "org" to mean organomegaly. Bad Idea Antonucci -->when I send out letters saying please go to howsyourhealth.organomegaly I did not look cool.On Mon, May 11, 2009 at 10:13 AM, Kathleen Patton <krpattoncomcast (DOT) net>wrote:Is it the way his system is pattern matching? I mean, he typed in "non tend" or "nt'" and got "non tendered" . Beats the heck out of me how he got "...not hearing voices" Anyone care to guess?I had mine set up for lots of shortcuts "St" meant "sore throat". You know that kind of stuff. It's made for some odd turns of phrases. Example: "applied a sugar tong splint on the left ankle" turned into "applied blood sugar tong to left ankle"I bet we could find some very funny episodes of pattern matching in our emr charts. Wait, wait! We could have IMP parlor games at IMP camp. 'Guess the Pattern Match' Kathleen (always looking for something to smile about.)I just got a note from an ortho colleague who just got AC THE NOTE SAYS FOR EXAM:"EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT PATIENTA RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT "AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT HEARING VOICES ,AND HAS NO LUMPS If he only knew I read this stuff.-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org-- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2009 Report Share Posted May 15, 2009 lol. just classic Wayne CoghillPractice ManagerMidtown Primary Carewww.doctorcoghill.com To: Sent: Monday, May 11, 2009 10:05:10 AMSubject: RE: EMR S Thanks for the laugh. I had a little girl go to the urologist, and he must have had a new EMR, because the exam showed she had a normal penis…. And the old records of a pt of mine came from her gyne, and it said on her bimanual exam that she had normal tonsils… J Eads, MD Pinnacle Family Medicine Colorado Springs, Colorado www.PinnacleFamilyMedicine.com From: [mailto: ] On Behalf Of Sent: Monday, May 11, 2009 7:41 AMTo: Subject: EMR S I just got a note from an ortho colleague who just got AC THE NOTE SAYS FOR EXAM:"EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT PATIENTA RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT "AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT HEARING VOICES ,AND HAS NO LUMPS If he only knew I read this stuff. -- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 16, 2009 Report Share Posted May 16, 2009 Of pertinence to EHR users is this article http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=590411 which warns of the potential liabilities that may come with using an EHR " Audited practices have been fined between $50,000 and $175,000 per physician for their inadvertent infractions. " The kicker is that the government is encouraging the use of certified EHRs, but, some of these EHRs have approved documentation tools that have been identified as potentially promoting the creation of fraudulent documentation. Caveat emptor. > > > lol. just classic > > Wayne Coghill > Practice Manager > Midtown Primary Care > www.doctorcoghill.com > > ________________________________ > > To: > Sent: Monday, May 11, 2009 10:05:10 AM > Subject: RE: EMR S > > > > Thanks for the laugh. > > > > I had a little girl go to the urologist, and he must have had a new EMR, > because the exam showed she had a normal penis…. > > > > And the old records of a pt of mine came from her gyne, and it said on her > bimanual exam that she had normal tonsils… > > J > > > > Eads, MD > > Pinnacle Family Medicine > > Colorado Springs, Colorado > > www.PinnacleFamilyMedicine.com > > > > > > > > From: > [mailto: ] On Behalf Of > Sent: Monday, May 11, 2009 7:41 AM > To: > Subject: EMR S > > > > > I just got a note from an ortho colleague who just got AC > THE NOTE SAYS FOR EXAM: > > " EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT > PATIENT > A RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT " > AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT > HEARING VOICES ,AND HAS NO LUMPS > > If he only knew I read this stuff. > > -- > If you are a patient please allow up to 24 hours for a reply by email/ > please note the new email address. > Remember that e-mail may not be entirely secure/ > MD > > > ph fax > impcenter.org > > -- Graham Chiu http://www.synapsedirect.com Synapse - the use from anywhere EMR. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2009 Report Share Posted May 17, 2009 This article seems mostly to refer to practices using automated E & M coders. It seems obvious to me that the E & M system is far too complicated and layered to trust any algorithmic system. I know that half of my claims could be disputed just because the system is impossibly open to interpretation. But I also know that I take responsibility for each of my codes and don't rely on any computer to code for me. Haresch > > > > > > lol. just classic > > > > Wayne Coghill > > Practice Manager > > Midtown Primary Care > > www.doctorcoghill.com > > > > ________________________________ > > > > To: > > Sent: Monday, May 11, 2009 10:05:10 AM > > Subject: RE: EMR S > > > > > > > > Thanks for the laugh. > > > > > > > > I had a little girl go to the urologist, and he must have had a new EMR, > > because the exam showed she had a normal penis…. > > > > > > > > And the old records of a pt of mine came from her gyne, and it said on her > > bimanual exam that she had normal tonsils… > > > > J > > > > > > > > Eads, MD > > > > Pinnacle Family Medicine > > > > Colorado Springs, Colorado > > > > www.PinnacleFamilyMedicine.com > > > > > > > > > > > > > > > > From: > > [mailto: ] On Behalf Of > > Sent: Monday, May 11, 2009 7:41 AM > > To: > > Subject: EMR S > > > > > > > > > > I just got a note from an ortho colleague who just got AC > > THE NOTE SAYS FOR EXAM: > > > > " EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT > > PATIENT > > A RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT " > > AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT > > HEARING VOICES ,AND HAS NO LUMPS > > > > If he only knew I read this stuff. > > > > -- > > If you are a patient please allow up to 24 hours for a reply by email/ > > please note the new email address. > > Remember that e-mail may not be entirely secure/ > > MD > > > > > > ph fax > > impcenter.org > > > > > > > > -- > Graham Chiu > http://www.synapsedirect.com > Synapse - the use from anywhere EMR. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2009 Report Share Posted May 17, 2009 That's part of it .. and I've seen EMRs that suggest doing something to reach a higher code .. which is exactly the type of activity they are considering fraudulent. In fact they are also suggesting the EMR be more capable and determine medical necessity ... I don't know how that that is going to work. But the wholesale generation of text is also highly suspect as in the examples posted earlier where the wrong gonads have been examined ie. examinations from other patients have been applied to the current patient. > > > This article seems mostly to refer to practices using automated E & M coders. > It seems obvious to me that the E & M system is far too complicated and > layered to trust any algorithmic system. I know that half of my claims could > be disputed just because the system is impossibly open to interpretation. > But I also know that I take responsibility for each of my codes and don't > rely on any computer to code for me. > > Haresch -- Graham Chiu http://www.synapsedirect.com Synapse - the use from anywhere EMR. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2009 Report Share Posted May 17, 2009 , maybe the little girl was Bobbit's daughter, and maybe the exminer in the second message just had very long fingers ? lol. just classic Wayne CoghillPractice ManagerMidtown Primary Carewww.doctorcoghill.com To: Sent: Monday, May 11, 2009 10:05:10 AMSubject: RE: EMR S Thanks for the laugh. I had a little girl go to the urologist, and he must have had a new EMR, because the exam showed she had a normal penis…. And the old records of a pt of mine came from her gyne, and it said on her bimanual exam that she had normal tonsils… J Eads, MD Pinnacle Family Medicine Colorado Springs, Colorado www.PinnacleFamilyMedicine.com From: [mailto: ] On Behalf Of Sent: Monday, May 11, 2009 7:41 AMTo: Subject: EMR S I just got a note from an ortho colleague who just got AC THE NOTE SAYS FOR EXAM: " EXAMINATION OF THE PATIENT'S SOCIAL REVEALS THAT SHE IS NON-TENDERED ABOUT PATIENTA RIGHT SECOND TOE IS ALSO NON-TENDERED OUTPATIENT " AND IN THE ROS THE VISIT WAS RE A SHOULDER - IT LET S ME KNOW SHE IS NOT HEARING VOICES ,AND HAS NO LUMPS If he only knew I read this stuff. -- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
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