Re: Re: organizing paperwork

[Guest guest]

Hi Larry,

Thanks for the update on the Labcorp/AC interface.

Progress sure is slow but it'll be nice if ever done.

I shred duplicates. Preliminary lab results I scan

into a pending lab folder or just let it sit as paper

til the final result comes. Duplicates are a little

nuisance but better than a missed report.

I scan everything myself and then file it directly in

the patient's chart. I find that quicker than having a

whole list of scanned items to re-open and file later.

By the time I finish leaving the patient a voice mail

or discussing their result, it's filed on their chart.

Gwen

--- brenthrabik wrote:

> This is not a stupid question at all . We have also

> struggled with

> this. It seems like we get 2-3 copies of everything

> either by fax,

> paper etc. In the old days they would pull the

> chart, find a copy

> of it there and then throw in the shredder. Our

> system w being

> paperless makes it easier to find, pull chart and

> file. Frequently

> I will delete a page if I already have sent letters

> regarding the

> lab report etc. We finally have the hospital only

> faxing reports

> and our lab. Some of the other doctors have caught

> on. Most have

> not.

> Brent

>

> > hello, everyone.

> >

> > i know that we're all thinking about the gulf

> coast, and the

> victims of the disasters, both natural and human,

> and doing what we

> each can. i find myself shocked and amazed by

> everything i've seen

> and heard. makes it difficult to focus on one's job

> at hand.

> >

> > i am wondering how others are handling reports and

> results, which

> may come by fax and mail, with some overlap, eg

> receiving the same

> piece of information twice or more by either method.

> >

> > i am using the fujitsu snapscan with adobe acrobat

> standard 7.0

> (which came with the scanner). i have hired someone

> to scan

> documents and then put them in binders, eg all

> imaging reports go

> into an imaging binder, and is then attached to the

> patient's chart

> (one of the features of AC), so i don't have to

> separately open

> documents on the server; they're already in the

> chart.

> >

> > i know this question may seem silly or stupid, and

> maybe i'm

> already supposed to know the answer. i'd like to

> know how others

> handle the blizzard of stuff which comes our way.

> how do you handle

> the mail on a daily basis? what if results by mail

> are not

> complete? do you scan them anyway? do you keep a

> hard copy? what

> system does one use to check off labs drawn and

> waiting for results,

> or with incomplete results reported, waiting for the

> complete

> results? what if the results also come by fax,

> which can also be

> easily converted to pdf, without scanning? do you

> just delete them,

> and then scan in the completed result? do you

> depend on the faxed

> results for a permanent record?

> >

> > for forms which patients bring in, i scan them

> right then and

> there, and that works well.

> >

> > i know this may seem like a fundamental question,

> and perhaps the

> answer is self-evident, but i would like to know in

> detail how

> others are handling this. please indulge me, i am

> looking to

> improve and be more efficient in every way.

> >

> > i have called the lab (labcorp), and i have asked

> them to only

> send new results, and in the format that is most

> readable, but

> they've not done so. on the flip side, they are

> working on a lab

> interface with AC, and the first part is almost

> complete, the

> ability to print out lab req's directly from AC onto

> their lab req;

> the second part, the ability of the server to

> directly receive lab

> results from the lab server will take more work and

> coordination

> with AC. in addition, i'm wondering in that case

> how results will

> checked.

> >

> > i have been more successful with radiology, now

> they only fax to

> me; previously they would fax and deliver by courier

> to me, so i

> only get one set of results now.

> >

> > thanks in advance for any and all help.

> >

> > larry

> >

> >

> > ---------------------------------

> > Click here to donate to the Hurricane Katrina

> relief effort.

>

>

>

[Guest guest]

Do you still have to keep the paper copy ?

Do you still have paper charts ? If yes, what do you keep in them ?

> Hi Larry,

>

> Thanks for the update on the Labcorp/AC interface.

> Progress sure is slow but it'll be nice if ever done.

>

> I shred duplicates. Preliminary lab results I scan

> into a pending lab folder or just let it sit as paper

> til the final result comes. Duplicates are a little

> nuisance but better than a missed report.

>

>

> I scan everything myself and then file it directly in

> the patient's chart. I find that quicker than having a

> whole list of scanned items to re-open and file later.

> By the time I finish leaving the patient a voice mail

> or discussing their result, it's filed on their chart.

>

>

> Gwen

>

> --- brenthrabik wrote:

>

>> This is not a stupid question at all . We have also

>> struggled with

>> this. It seems like we get 2-3 copies of everything

>> either by fax,

>> paper etc. In the old days they would pull the

>> chart, find a copy

>> of it there and then throw in the shredder. Our

>> system w being

>> paperless makes it easier to find, pull chart and

>> file. Frequently

>> I will delete a page if I already have sent letters

>> regarding the

>> lab report etc. We finally have the hospital only

>> faxing reports

>> and our lab. Some of the other doctors have caught

>> on. Most have

>> not.

>> Brent

>>

>>> hello, everyone.

>>>

>>> i know that we're all thinking about the gulf

>> coast, and the

>> victims of the disasters, both natural and human,

>> and doing what we

>> each can. i find myself shocked and amazed by

>> everything i've seen

>> and heard. makes it difficult to focus on one's job

>> at hand.

>>>

>>> i am wondering how others are handling reports and

>> results, which

>> may come by fax and mail, with some overlap, eg

>> receiving the same

>> piece of information twice or more by either method.

>>>

>>> i am using the fujitsu snapscan with adobe acrobat

>> standard 7.0

>> (which came with the scanner). i have hired someone

>> to scan

>> documents and then put them in binders, eg all

>> imaging reports go

>> into an imaging binder, and is then attached to the

>> patient's chart

>> (one of the features of AC), so i don't have to

>> separately open

>> documents on the server; they're already in the

>> chart.

>>>

>>> i know this question may seem silly or stupid, and

>> maybe i'm

>> already supposed to know the answer. i'd like to

>> know how others

>> handle the blizzard of stuff which comes our way.

>> how do you handle

>> the mail on a daily basis? what if results by mail

>> are not

>> complete? do you scan them anyway? do you keep a

>> hard copy? what

>> system does one use to check off labs drawn and

>> waiting for results,

>> or with incomplete results reported, waiting for the

>> complete

>> results? what if the results also come by fax,

>> which can also be

>> easily converted to pdf, without scanning? do you

>> just delete them,

>> and then scan in the completed result? do you

>> depend on the faxed

>> results for a permanent record?

>>>

>>> for forms which patients bring in, i scan them

>> right then and

>> there, and that works well.

>>>

>>> i know this may seem like a fundamental question,

>> and perhaps the

>> answer is self-evident, but i would like to know in

>> detail how

>> others are handling this. please indulge me, i am

>> looking to

>> improve and be more efficient in every way.

>>>

>>> i have called the lab (labcorp), and i have asked

>> them to only

>> send new results, and in the format that is most

>> readable, but

>> they've not done so. on the flip side, they are

>> working on a lab

>> interface with AC, and the first part is almost

>> complete, the

>> ability to print out lab req's directly from AC onto

>> their lab req;

>> the second part, the ability of the server to

>> directly receive lab

>> results from the lab server will take more work and

>> coordination

>> with AC. in addition, i'm wondering in that case

>> how results will

>> checked.

>>>

>>> i have been more successful with radiology, now

>> they only fax to

>> me; previously they would fax and deliver by courier

>> to me, so i

>> only get one set of results now.

>>>

>>> thanks in advance for any and all help.

>>>

>>> larry

>>>

>>>

>>> ---------------------------------

>>> Click here to donate to the Hurricane Katrina

>> relief effort.

>>

>>

>>

>

>

>

>

>

>

[Guest guest]

On the paper trail from the MD/DVM in Drain, Oregon;

About the paperwork I (and you too) have while handling a "paperless office"...... What a hassle for me, especially when I am setting up and have all those records sent to me from other MDs who don't care about the huge pile of useless paper in the binder. I try to save my chart space so I have consolidated all the consent forms into a single page I discuss one time with the new patient; all the privacy things are also consolidated onto one page, and the authorization to treat and the request for old records are onto a third page. Admit papers are scanned into the record after I review them with the patient to be sure they are complete and understood, and I have offered more information to them. Then the forms are shredded: one of the consent items is permission to use a copy in place of the original.

With the old records that come in I cream through them for necessary paper. Lab results seem to have a cover page, a result page and a final page of computer gobbledegook. If the result page has a good heading with all the information on it that is all I keep. I don't keep INRs three years back or duplicate notes from consultants. I separate hospital discharge forms and scan them separately. Same with procedure notes and echocardiograms and EKGs and their ilk, making sure anything significant is on my record and that I have initialed the scanned document. The rest I scan as "old records" unless something is vital. I am careful to update my medical record with surgery dates and old medications, negative effects, or unmentioned previous diagnoses when I scan, so I rarely need to look these things through again. This takes more time than I want it to take.

For my own lab results, I have a folder for the MD copy of the lab request kept near the computer desk along with a notebook showing consecutively by date all lab orders, last name of subject, and result return date (an old habit from my American Animal Association days) and between these two things I can tell what has returned. I consider the result that causes me to call to tell the results to the patient the most salient result. I sign the final return, and scan it in. I call the patient, tell them the result and offer the result page the them. If they want it I file it by the front desk in an alphebetical file of "things to give my patients when they come in" which includes these pages, the insurance data they left behind on the desk, the handouts I promised to get for them, the social security form I won't fill out without them being present, etc, etc. I only give one result

page to the patient, extra copies would confuse them. Look how much it confuses us.

If an early partial result comes (or any result, final or early) with significant findings, I call the patient about it and open an EMR encounter which I fill with my phone recommendations and the patient's response by phone, that way I have a chart record if I recommended someone to come in or to change their meds and they agreed and didn't comply. I also note my response on the lab when I initial it prior to scanning. That gives me something to do with my hands while talking to the patient on the phone. If the result means I have a new diagnosis I put it in the active disease section of the record and if it quiets a fear I update the inactive part. Some things are recorded consecutively such as HbA1c under the diabetes diagnosis. I use the "old diagnosis" section a lot for most recent normal labs so I don't have to look them up under a different section of the record: I update as they change. Only most recent labs,

though, since my old ones have been scanned in in case I need them.

I keep a notebook log of phone calls from patients; these are important in case someone calls about a problem and you suggest something they do not do (and covers those who are not patients of yours as well as calls that someone other than you pick up). I don't log every call, from the bank, my daughter, the follow up call from respiratory therapist that she is on the way, unless the call relates to patient care. If I had lots of support staff I would log it all because I've seen secretaries who will call in flower and card orders, manage reception caterers, plan staff, invite guests, and organize entire wedding receptions using hours of the bosses time. Just keeping the records stops them cold.

I delay the shredding of the registration form and insurance card until the billing expert puts all that in the billing system, to save her time digging through the EMR. These are clipped to each other in a pile with a sticky note of what I have done with them all ready, listed on the front of the registration, so we don't get confused. Maybe this won't be such a hassel when I have fewer new patients in the practice. She only comes in once a week and I am impatient to shred these messy things.

I think that is all I do with papers. Oh, that doesn't count Quick-Books Pro, the business management program and its ancillary documentation, which is a different can of worms entirely.

Joanne Holland DVM/MD

> > i am wondering how others are handling reports and results, whichmay > > come by fax and mail, with some overlap, eg receiving the samepiece > > of information twice or more by either method.> > > > i am using the fujitsu snapscan with adobe acrobat standard 7.0(which > > came with the scanner). i have hired someone to scan documentsand > > then put them in binders, eg all imaging reports go into animaging > > binder, and is then attached to the patient's chart (one of the > > features of AC), so i don't have to separately open documents onthe > > server; they're already in the chart.> > > > i know this question may seem silly or stupid, and maybe i'malready > > supposed to know the answer. i'd like to know how others handlethe > > blizzard of stuff which comes our

way. how do you handle themail on > > a daily basis? what if results by mail are not complete? do youscan > > them anyway? do you keep a hard copy? what system does one useto > > check off labs drawn and waiting for results, or with incomplete > > results reported, waiting for the complete results? what if the > > results also come by fax, which can also be easily converted topdf, > > without scanning? do you just delete them, and then scan in the > > completed result? do you depend on the faxed results for apermanent > > record?> > > > for forms which patients bring in, i scan them right then andthere, > > and that works well.> > > > i know this may seem like a fundamental question, and perhaps the > > answer is self-evident, but i would like to know in detail

howothers > > are handling this. please indulge me, i am looking to improveand be > > more efficient in every way.> > > > i have called the lab (labcorp), and i have asked them to onlysend > > new results, and in the format that is most readable, but they'venot > > done so. on the flip side, they are working on a lab interfacewith > > AC, and the first part is almost complete, the ability to printout > > lab req's directly from AC onto their lab req; the second part,the > > ability of the server to directly receive lab results from thelab > > server will take more work and coordination with AC. inaddition, i'm > > wondering in that case how results will checked.> > > > i have been more successful with radiology, now they only fax tome; > > previously they would fax and deliver

by courier to me, so i onlyget > > one set of results now.> > > > thanks in advance for any and all help.> > > > larry> >

Yahoo! for Good Click here to donate to the Hurricane Katrina relief effort.

[Guest guest]

Hi Anemaria,

I shred pretty much all paper except original licenses

and contracts Medicare patients signed after I opted

out. I have multiple copies of my computer files and

medical records (on and off site).

Gwen

--- Anemaria Lutas wrote:

> Do you still have to keep the paper copy ?

> Do you still have paper charts ? If yes, what do you

> keep in them ?

>

>

>

> > Hi Larry,

> >

> > Thanks for the update on the Labcorp/AC interface.

> > Progress sure is slow but it'll be nice if ever

> done.

> >

> > I shred duplicates. Preliminary lab results I scan

> > into a pending lab folder or just let it sit as

> paper

> > til the final result comes. Duplicates are a

> little

> > nuisance but better than a missed report.

> >

> >

> > I scan everything myself and then file it directly

> in

> > the patient's chart. I find that quicker than

> having a

> > whole list of scanned items to re-open and file

> later.

> > By the time I finish leaving the patient a voice

> mail

> > or discussing their result, it's filed on their

> chart.

> >

> >

> > Gwen

> >

> > --- brenthrabik wrote:

> >

> >> This is not a stupid question at all . We have

> also

> >> struggled with

> >> this. It seems like we get 2-3 copies of

> everything

> >> either by fax,

> >> paper etc. In the old days they would pull the

> >> chart, find a copy

> >> of it there and then throw in the shredder. Our

> >> system w being

> >> paperless makes it easier to find, pull chart and

> >> file. Frequently

> >> I will delete a page if I already have sent

> letters

> >> regarding the

> >> lab report etc. We finally have the hospital

> only

> >> faxing reports

> >> and our lab. Some of the other doctors have

> caught

> >> on. Most have

> >> not.

> >> Brent

> >>

> >>> hello, everyone.

> >>>

> >>> i know that we're all thinking about the gulf

> >> coast, and the

> >> victims of the disasters, both natural and human,

> >> and doing what we

> >> each can. i find myself shocked and amazed by

> >> everything i've seen

> >> and heard. makes it difficult to focus on one's

> job

> >> at hand.

> >>>

> >>> i am wondering how others are handling reports

> and

> >> results, which

> >> may come by fax and mail, with some overlap, eg

> >> receiving the same

> >> piece of information twice or more by either

> method.

> >>>

> >>> i am using the fujitsu snapscan with adobe

> acrobat

> >> standard 7.0

> >> (which came with the scanner). i have hired

> someone

> >> to scan

> >> documents and then put them in binders, eg all

> >> imaging reports go

> >> into an imaging binder, and is then attached to

> the

> >> patient's chart

> >> (one of the features of AC), so i don't have to

> >> separately open

> >> documents on the server; they're already in the

> >> chart.

> >>>

> >>> i know this question may seem silly or stupid,

> and

> >> maybe i'm

> >> already supposed to know the answer. i'd like to

> >> know how others

> >> handle the blizzard of stuff which comes our way.

> >> how do you handle

> >> the mail on a daily basis? what if results by

> mail

> >> are not

> >> complete? do you scan them anyway? do you keep

> a

> >> hard copy? what

> >> system does one use to check off labs drawn and

> >> waiting for results,

> >> or with incomplete results reported, waiting for

> the

> >> complete

> >> results? what if the results also come by fax,

> >> which can also be

> >> easily converted to pdf, without scanning? do

> you

> >> just delete them,

> >> and then scan in the completed result? do you

> >> depend on the faxed

> >> results for a permanent record?

> >>>

> >>> for forms which patients bring in, i scan them

> >> right then and

> >> there, and that works well.

> >>>

> >>> i know this may seem like a fundamental

> question,

> >> and perhaps the

> >> answer is self-evident, but i would like to know

> in

> >> detail how

> >> others are handling this. please indulge me, i

> am

> >> looking to

> >> improve and be more efficient in every way.

> >>>

> >>> i have called the lab (labcorp), and i have

> asked

> >> them to only

> >> send new results, and in the format that is most

> >> readable, but

> >> they've not done so. on the flip side, they are

> >> working on a lab

> >> interface with AC, and the first part is almost

> >> complete, the

> >> ability to print out lab req's directly from AC

> onto

> >> their lab req;

> >> the second part, the ability of the server to

> >> directly receive lab

> >> results from the lab server will take more work

> and

> >> coordination

> >> with AC. in addition, i'm wondering in that case

> >> how results will

> >> checked.

> >>>

> >>> i have been more successful with radiology, now

> >> they only fax to

> >> me; previously they would fax and deliver by

> courier

> >> to me, so i

> >> only get one set of results now.

> >>>

> >>> thanks in advance for any and all help.

> >>>

> >>> larry

> >>>

> >>>

> >>> ---------------------------------

> >>> Click here to donate to the Hurricane Katrina

> >> relief effort.

> >>

> >>

> >>

> >

> >

> >

> >

> >

> >