Curse of the $0 Invoice
Hi, I have recently been trying to encourage staff to use the workflow (CheckIn->Consult->CheckOut). This is new for us as this is not how we were initially taught to use the system. However we still are having some issues. In particular:
- Generation of $0 invoices that sit in the "Work In Progress" list.
- Clinicians pressing the "Consult" button and then adding a note only to have it added to an older "In Progress" visit rather than the most recent visit.
- Sometimes when press "Consult" an older completed invoice is displayed even though there is a newer in progress invoice.
I think the reason I have not been able to work out why this is happening is because I don't understand when invoices are generated and when visits are completed. Or what happens when you have many old "In Progress" visits because we were previously using the system incorrectly...
So, I was wondering if someone might please be able to explain:
- When are new invoices generated?
- When do visits get completed?
- When pressing the "Consult" button what visit a note is added to.
- If anybody else has these issues and how you manage them.
Thanking you,
Adrian
Re: Curse of the $0 Invoice
Adrian - can you read http://www.openvpms.org/documentation/csh/1.7/concepts/schedulesWorklists
With luck this should help you. If it is clear as mud, then tell me what parts you have difficulty with.
To address your questions:
- When are new invoices generated?
either when you use Customers|Charges|New|Invoice [not the preferred way] or when you do the check-in "if no open invoice exists, a new one is created"
- When do visits get completed?
very simplisticly, when you do the check-out. However remember that we have an invoice, an appointment, a task, and a visit all of which have a status 'Complete'. The above text, especially its Status Update section should help. However, I not that perhaps I should add Visit columns to the Status Update table. Note also that the visit status (which can only be Complete and In-Progress) is initially set to Complete when the visit is created as part of the check-in process and is then switched to InProgress when you press OK to exit the visit editor and will be set to Complete when you do the check-out.
You might also want to read http://www.openvpms.org/documentation/csh/1.7/concepts/visits
- When pressing the "Consult" button what visit a note is added to.
simple answer - the one that is selected - is the one coloured blue. On the medical records summary tab (displayed either as part of the visit editor when you press consult, or the Patients|Medical Records screen), when you do New|Note this note will get added under the currently selected visit.
Note that if you have the system in a peculiar state (as I do because of the testing I have been doing), it is quite possible to select a worklist entry, and press Consult, and have the visit editor display the summary with the select (blue) visit being an old one because more recent visits being added.
- If anybody else has these issues and how you manage them.
Sorry - can't help - the Hong Kong practice has not yet switched to OpenVPMS - I have acquired the above info by playing with the system in order to document it.
Finally - note that above CSH text is for 1.7 and includes references to facilities (like the ability to not have the New Weight screen presented as part of the check-in) but is generally applicable to 1.6.
Regards, Tim G
Re: Curse of the $0 Invoice
When pressing Consult, the Visit used will be the one that is dated closest to the Appointment or Task.
You will get a $0 invoice if:
-Tim A
Re: Curse of the $0 Invoice
Hi,
I am guessing this is what is happening but think I will need to do some peering over shoulders of certain staff members to work this out.
Or people are checking patients back in if they have not finished writing notes after discharge.
Re: Curse of the $0 Invoice
This was where I always thought a in work flow "MOVE TO WORKLIST" button was appropriate...ie u can set up each staff member witha todo list and they can move stuff to that list when they still need to do notes or call backs etc.
Re: Curse of the $0 Invoice
Hi, This would be helpful but I am not sure if it would prevent what I now think is happening.
People are either checking patients back in to remember to write them up later
OR
checking them out, then adding them to a worklist manually and then consulting them (thus consulting from a completed visit).
I think the latter is what is happening.
So, my initial thought is that without checking something in, you should not be able to "Consult" it from a worklist. If it is added to a worklist manually it you should probably be able to navigate to the record and add notes, etc that way, but not enter the "Visit" screen as this is I think in our case at least what is generating these $0 invoices on cases that really are closed, but just need editing post check out.
Thoughts?
Re: Curse of the $0 Invoice
One way to avoid it would be to display a warning if a consult is being done on a Visit that has a finalised invoice.
E.g.: "The Invoice for this Visit has already been finalised. Performing another Consult will create a new Invoice."
For the "Move to Worklist" suggestion, there is the Followup task list project, which still needs some feedback.
-Tim
Re: Curse of the $0 Invoice
A warning is one way of doing it, however having had people delete invoices inadvertently despite there being a warning to prevent this, my suspicion is people will just click through the warning box.
I guess my question is if the "Consult" button is present for non-checked in worklist entries deliberatly? If so, why? The check out button is also present for them. If we want people to follow the "Check-In -> Consult -> Check-Out pathway this lets them enter halfway and cause issues.
It also means the "Worklist" is a mix of patients that are "Checked In" but may not be in hospital or in the middle of a visit (e.g. we have a blood donors list as a worklist) and truely "checked in and In hospital" patients.
The button above might not change much. If you are clicking Consult because you want to keep adding notes then you are unlikely to click "No" and then go another way to edit the patient. Most people will just click "Yes" and create a new invoice without regards to the havoc created behind the scenes.
My thoughts are:
Option 1) A warning if a consult is being done on a Visit that has a finalised invoice. E.g.: "The Invoice for this Visit has already been finalised. Would you like to create a new invoice" -> Yes or No
Option 2) If a patient is manually placed in the worklist they should not be able to be "consulted" or checked out. These are only options that shold be available if a patient has been "checked in". I.e. is acutally in hospital. To edit notes you will neck to click and then go through the box on the left of the screen.