SmartflowSheet
Did SmartFlowsheet provide any documentation outline the API they have made available? I was just looking at a method to enable us to select a template at checkin among other things.
I can see its supported but I wondered if the API allows a retrieval of the current list. If not I can just use a hardcoded entry per worklist.
Re: SmartflowSheet
No Greta - OpenVPMS communicates at Flow Sheet creation only - it doesnt perform any sort of live update in the current iteration.
That might change once we are integrating billing etc.
Re: SmartflowSheet
Ok cool. We will just have to get our clinicians into the habit of getting it right the first time :)
Re: SmartflowSheet
Hi,
Is there a way to make the Visit.Reason a free typed box (rather than a lookup)?
Re: SmartflowSheet
Its one of those catch 22's
Yes it can be done.
but you can never go back to lookups
You will end with 10 different spellings for each reason due to mistypes and confusion.
What your real issue is :- Visit.Reason in OpenVPMS and Problem in SmartflowSheet are different things
Usually when an animal is presented it presents for reasons such as " Coughing" or "Epistaxis" or " Itchy" these are not really what we want shown in a Problem on SFS. We want a diagnosis or atleast presumptive ddx. I.E we want "IMHA" or "ITP" or even the whole word rather than anacronyms...ie Moist Excoriative Dermatitis.
Changing Visit reason to a typed box isnt going to solve the problem as vets havent even examined the patient when its entered...during appointment creation.
Ideally what needs to change for you is that when you hit the "Create New SFS" button it checks the pet history for a unresolved Problem entry and uses that.
Thoughts?
To be clear I suspect flowsheets current format and itegration suits your day to day surgical type stuff not really a critical care scenario.
Re: SmartflowSheet
Hi Ben,
Yep, that makes sense. I just feel a bit limited by the lookups and trying to figure out how to get around it.
What my main goal is for the Vet to direct what the patients problems/procedures are from OpenVPMS (and not need to go into SFS) to add the problems/procedures. OpenVPMS needs to direct everything.
I'd like this to be done at the time of the consent form created + the New Flowsheet button pressed.
I don't mind where the information is dragged from (visit.reason is fine), but there are so many variables in practice, that selecting just "fracture repair" doesn't tell the whole story to the staff in the treatment area. The patient may need a fracture repaired, but it also needs it's right eye removed. To have every possible problem/procedure as a single lookup would be 1000's long. Hence, wanting free text.
Problems is fine too, we can use that, but can that be free type (rather than a lookup)?
What are the implications (other than having multiple spellings) of having visit.reason not be a lookup? Is it for future use of the program - reporting?
Greta
Re: SmartflowSheet
Understood -
I reckon that if the Vet could add multiple problems to the patients visit and when they hit Create new SFS the unresovled ones are sent to SFS...
whether the problems are Freetype or lookup is a choice.
Re: SmartflowSheet
Personally i find the VENOM problems for both presentation and diagnosis fairly comprehensive...
Re: SmartflowSheet
So something like: -
Would upload as 2 problems to SFS
1. Appetite Decreased (Undiagnosed)
2. Intoxication - theobromine/Chocolate
Thoughts
Re: SmartflowSheet
Ok, that sounds good. We can use problems. Then it can be multiple problems, which I like.
I presume we would need to wait until a future version of OpenVPMS to make the Problems push through to the SFS?
When a visit is completed, is there a way to make the Problems Resolve automatically?
Greta
Re: SmartflowSheet
Well
We could but ideally problems should be resolved by a vet as they are actually resolved via treatment.
For example if a dog was diagnosed diabetic last visit (2mth ago) and represents for seizures.
I cant imagine you wouldnt want it (diabetes) on the SFS problem list
ie it would be
1. Seizureing (undiagnosed)
2. Diabetes mellitus (13/8/2016)
My thoughts are we could add all unresolved problems with the newest first, and add the date for unresolved problems that are outstanding for more than say 7 days.
We could add an option that RESOLVES problems when a visit is completed but I think this is a bit sledge hammer ish
Re: SmartflowSheet
Yes, that totally makes sense.
I suppose if the Vet is the person going into the Problems list to add new ones (today's procedure), then they will see any unresolved Problems and be able to resolve them if they are old.
Having them sorted by newest at the top would be perfect.
Re: SmartflowSheet
Well unless anyone else has anything to add ..?
Re: SmartflowSheet
When you add a Problem, is it possible to have Procedure (as well as Presenting Complaint & Diagnosis)?
Ie:
Presenting Complaint
Procedure
Diagnosis
I'd prefer them all to be free type (rather than look up), but at least if the Procedure is free type, that would be great.
Re: SmartflowSheet
We've largely moved away from free-form text for classification, because:
In your case, you want to be able to send multiple problems and procedures to SFS.
We don't have any facility for supporting procedures as these are tied in with charging, and there isn't a good way of identifying what is a procedure. It's also not clear how this would be integrated with SFS, as only a single treatment template can be specified, and at flow sheet creation.
We could support multiple problems by:
Of these, 1. is the more elegant solution, but may not fit in with your existing worrkflow. You may need to enable the Problems tab in the Visit Editor for example.
2. would make reporting difficult. E.g. if a patient is given visit reasons 'Cat Spey' and 'Vaccination' how should the visit appear in practice reports?
3. has issues for record locking. If the summary part of the visit, it can be changed at any time. We could improve this by versioning summaries so you can see the summary over time. The summary could default to the Visit Reason.
Re: SmartflowSheet
Additionally adding to Tims comment.
EMR is how SFS refers to the software practice management systems.
We are somewhat limited by SFS at the moment.
Currently it requires if we want 2 way communication we open a port to our systems...this represents a security risk. Its basically opening a hole to a third party...the better way for us is to use polling...this is where intermittantly we send a message to SFS and ask if there is anything new...
SFS doesnt have 2 way flow on treatments currently...its only 1 way back to the EMR..
So we need SFS to implement a mailbox of sorts...
Secondly the fact your considering storing a procedure in a problem list represents a problem with SFS. SFS has task lists more ideally suited to that info...but currently has no method to dynamically update them when a proceedure is billed in the EMR.