Guest guest Posted January 26, 2008 Report Share Posted January 26, 2008 Gordon That ppt appears to be related to PCP referring to specialists, whereas my question relates to the quality and formatting of information being sent back to the PCP when the patient is under the specialist's regular care for a specific condition. Does one prefer prose, bullet points or what? > > > > > > > One nice piece of work that informs how primary care and specialists might > work better together is captured in the " Yellow Card " agreement (work done > in Minneapolis MN, USA). > The authors attempted to capture the basic information flow that ought to > occur on both sides. This has formed the foundation of many a successful > " service agreement. " > Gordon > > > At 03:47 PM 1/26/2008, you wrote: > > > For your patients who are being seen by specialists, how would you > react to a follow up letter with headings like this ( this is for an > arthritis patient ) ? > > Reason for review: > Drug Compliance: > Adverse Effects: > Toxicity Screening: > Joint Examination: > Joint Injections: > Assessment: > Medication Changes: > Follow Up: > > -- > Graham Chiu > http://www.synapsedirect.com > Synapse-EMR - innovative electronic medical records system -- Graham Chiu http://www.synapsedirect.com Synapse-EMR - innovative electronic medical records system Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2008 Report Share Posted January 26, 2008 Bullet points are great. Less reading. GuinnGordonThat ppt appears to be related to PCP referring to specialists,whereas my question relates to the quality and formatting ofinformation being sent back to the PCP when the patient is under thespecialist's regular care for a specific condition.Does one prefer prose, bullet points or what?On Jan 27, 2008 10:01 AM, L. Gordon <gmooreidealhealthnetwork> wrote:>>>>>>> One nice piece of work that informs how primary care and specialists might> work better together is captured in the "Yellow Card" agreement (work done> in Minneapolis MN, USA).> The authors attempted to capture the basic information flow that ought to> occur on both sides. This has formed the foundation of many a successful> "service agreement."> Gordon>>> At 03:47 PM 1/26/2008, you wrote:>>> For your patients who are being seen by specialists, how would you> react to a follow up letter with headings like this ( this is for an> arthritis patient ) ?>> Reason for review:> Drug Compliance:> Adverse Effects:> Toxicity Screening:> Joint Examination:> Joint Injections:> Assessment:> Medication Changes:> Follow Up:>> --> Graham Chiu> http://www.synapsedirect.com> Synapse-EMR - innovative electronic medical records system-- Graham Chiuhttp://www.synapsedirect.comSynapse-EMR - innovative electronic medical records system Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2008 Report Share Posted January 26, 2008 This part focuses on what a specialist might communicate to a PCP: Specialty Care 1. State that you are returning the patient to primary care for follow-up in response to their consult request 2. What you did for the patient and the results 3. Answers to Primary Care Physicians questions in their consult request 4. Your thought process in arriving at your answers 5. Recommendations for the Primary Care Physician and educational notes as appropriate 6. When or under what circumstances the Primary Care Physician should consider sending the patient back to you At least this covers a consultation. Referral would be different. G At 04:19 PM 1/26/2008, you wrote: Gordon That ppt appears to be related to PCP referring to specialists, whereas my question relates to the quality and formatting of information being sent back to the PCP when the patient is under the specialist's regular care for a specific condition. Does one prefer prose, bullet points or what? On Jan 27, 2008 10:01 AM, L. Gordon < gmoore@...> wrote: > > > > > > > One nice piece of work that informs how primary care and specialists might > work better together is captured in the " Yellow Card " agreement (work done > in Minneapolis MN, USA). > The authors attempted to capture the basic information flow that ought to > occur on both sides. This has formed the foundation of many a successful > " service agreement. " > Gordon > > > At 03:47 PM 1/26/2008, you wrote: > > > For your patients who are being seen by specialists, how would you > react to a follow up letter with headings like this ( this is for an > arthritis patient ) ? > > Reason for review: > Drug Compliance: > Adverse Effects: > Toxicity Screening: > Joint Examination: > Joint Injections: > Assessment: > Medication Changes: > Follow Up: > > -- > Graham Chiu > http://www.synapsedirect.com > Synapse-EMR - innovative electronic medical records system -- Graham Chiu http://www.synapsedirect.com Synapse-EMR - innovative electronic medical records system Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2008 Report Share Posted January 26, 2008 Thanks . I'm thinking bullet points are good for routine follow ups, and prose is better where you wish to pass on some educational point, or management plan. > > > > > > > Bullet points are great. Less reading. > Guinn > -- Graham Chiu http://www.synapsedirect.com Synapse-EMR - innovative electronic medical records system Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2008 Report Share Posted January 26, 2008 I like the bullet points too, just have to warn you that ''compliance'' is on the non PC word list (more PC(CC)) to talk about ? 'adherence') I think it was a reaction to the older paternalistic non patient centered approach. (Does not bug me personally)A paragraph at the end would be great for education.LynnTo: From: compkarori@...Date: Sun, 27 Jan 2008 12:32:40 +1300Subject: Re: follow up letters Thanks . I'm thinking bullet points are good for routine follow ups, and prose is better where you wish to pass on some educational point, or management plan. On Jan 27, 2008 10:36 AM, Guinn <NGuinn555comcast (DOT) net> wrote: > > > > > > > Bullet points are great. Less reading. > Guinn > -- Graham Chiu http://www.synapsedirect.com Synapse-EMR - innovative electronic medical records system Connect and share in new ways with Windows Live. Get it now! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2008 Report Share Posted January 27, 2008 This is a great topic. I never feel we communicate enough. I frequently send my detailed notes to specialists FYI to keep them updated on med changes, my thoughts, and if I have specific questions, I ask them explicitly with either underlined and/or bold formatting or a cover letter. Of course, I don't hesitate to call when appropriate. Gordon often talks about how there is so much distraction by bureaucracy of so many types - that takes away from actual patient care. Our notes are a great example. We need to document to meet the E & M minimums to get paid for those services. What would be nice would be a clean, concise bulleted note on what is going on and what the specific recommendations are rather than the typical blow-by-blow H & P that we have already been through. A quarter or half page synopsis with a clear assessment and plan would be a delightful help v reading through a 2-3 page detailed letter.Jacques Guillot, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2008 Report Share Posted January 27, 2008 Prose or bullets do not matter to me certainlywhat matters to me is whether the consult looks as if it was done to answer what the patient and i askedA medical report about the rheumatological status of the patient that does not however address the specifc rheumatological problem I sent them for is what happens sometimes This may all be obvious to you Graham becasue you do it well,but in reality consultants see my patients wihtout having my note in front of them " oh we do not always get notes so we do not look tos ee if we have one " etc If a consultants note says perhaps that the patient says there has been wt loss but I note that i haven't documetned any.. we lose communication. that is the basic gist of it for me- to tell you what I need and for you to answer that need(whether you know any answer or not but to address the question the patient and I asked) Gordon That ppt appears to be related to PCP referring to specialists, whereas my question relates to the quality and formatting of information being sent back to the PCP when the patient is under the specialist's regular care for a specific condition. Does one prefer prose, bullet points or what? > > > > > > > One nice piece of work that informs how primary care and specialists might > work better together is captured in the " Yellow Card " agreement (work done > in Minneapolis MN, USA). > The authors attempted to capture the basic information flow that ought to > occur on both sides. This has formed the foundation of many a successful > " service agreement. " > Gordon > > > At 03:47 PM 1/26/2008, you wrote: > > > For your patients who are being seen by specialists, how would you > react to a follow up letter with headings like this ( this is for an > arthritis patient ) ? > > Reason for review: > Drug Compliance: > Adverse Effects: > Toxicity Screening: > Joint Examination: > Joint Injections: > Assessment: > Medication Changes: > Follow Up: > > -- > Graham Chiu > http://www.synapsedirect.com > Synapse-EMR - innovative electronic medical records system -- Graham Chiu http://www.synapsedirect.com Synapse-EMR - innovative electronic medical records system -- MD ph fax remember mail may not be perfectly secure Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2008 Report Share Posted January 27, 2008 oh sorry- well answered me thinks i do not yet know how to work my new email.But i got color and fonts!! and a signature. This part focuses on what a specialist might communicate to a PCP: Specialty Care 1. State that you are returning the patient to primary care for follow-up in response to their consult request 2. What you did for the patient and the results 3. Answers to Primary Care Physicians questions in their consult request 4. Your thought process in arriving at your answers 5. Recommendations for the Primary Care Physician and educational notes as appropriate 6. When or under what circumstances the Primary Care Physician should consider sending the patient back to you At least this covers a consultation. Referral would be different. G At 04:19 PM 1/26/2008, you wrote: Gordon That ppt appears to be related to PCP referring to specialists, whereas my question relates to the quality and formatting of information being sent back to the PCP when the patient is under the specialist's regular care for a specific condition. Does one prefer prose, bullet points or what? On Jan 27, 2008 10:01 AM, L. Gordon < gmoore@...> wrote: > > > > > > > One nice piece of work that informs how primary care and specialists might > work better together is captured in the " Yellow Card " agreement (work done > in Minneapolis MN, USA). > The authors attempted to capture the basic information flow that ought to > occur on both sides. This has formed the foundation of many a successful > " service agreement. " > Gordon > > > At 03:47 PM 1/26/2008, you wrote: > > > For your patients who are being seen by specialists, how would you > react to a follow up letter with headings like this ( this is for an > arthritis patient ) ? > > Reason for review: > Drug Compliance: > Adverse Effects: > Toxicity Screening: > Joint Examination: > Joint Injections: > Assessment: > Medication Changes: > Follow Up: > > -- > Graham Chiu > http://www.synapsedirect.com > Synapse-EMR - innovative electronic medical records system -- Graham Chiu http://www.synapsedirect.com Synapse-EMR - innovative electronic medical records system -- MD ph fax remember mail may not be perfectly secure Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2008 Report Share Posted January 27, 2008 Jean This is all part of various experiments I am carrying out to document an encounter quickly. I think the old SOAP method is now passe, though was great when one was using pen and paper. Today, with the computer, we can create far more categories specific to a particular condition. Generating prose for a letter is difficult as the text becomes rather repetitive and stilted. So, I'm moving away from that. So, here's a dummy encounter I created yesterday. Jerry Park has been feeding me some ideas http://synapse-movies.s3.amazonaws.com/Synapse-chained-macros.wmv > > > > > > > oh sorry- well answered > me thinks i do not yet know how to work my new email. > But i got color and fonts!! and a signature. > -- Graham Chiu http://www.synapsedirect.com Synapse-EMR - innovative electronic medical records system Quote Link to comment Share on other sites More sharing options...
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