Transcript Reminder Dialogs edited

Reminder Dialogs
Introduction
• Reminder Dialogs allow a user to resolve the
reminder by entering data into the progress
note and PCC
• Saves a step and user does not need to do any
typing
• Dialogs can be turned into templates to be
used on the notes tab
Introduction
• Dialogs are usually a resolution to a reminder
– i.e. documentation of a diabetic foot exam
• However, they may be used to enter PCC data
even if there isn’t a reminder, as in patient
education
What is a dialog?
• Way to record data in
PCC and in progress
note
• Looks like TIU template
What is a dialog?
• One click can open up
other choices
• Can use check boxes or
radio buttons
• As the user opens up a
box, data goes into the
progress note and/or
PCC
What is a dialog?
• Prompts for comments
can be added
• Health factor of
PREVIOUS SMOKER was
added to PCC
• Progress note is being
created
What is a dialog?
• Education topics can be
addressed
• Prompt for level of
understanding
What is a dialog?
• When finished is
clicked, the data is
inserted into the
progress note
• The data that went to
PCC is visible at the
bottom
PCC Data
Data went to
PCC and is on
the wellness
tab
3 ways to get a dialog
• Import one through Reminder Exchange
• Auto-generate one after a reminder is created
• Create one from scratch making each piece
Dialog Menus
• Start out on the main
Reminder Manager
Menu
• Menu is DM Reminder
Dialog Management
• Only 2 options
• Dialog Parameters
• Reminder Dialogs
DI- Reminder Dialogs
• Opens up to the
reminders View
• Use CV to see the
other items
Dialog Pieces
Choose from:
P
prompt
E
dialog element
R
reminder dialog
F
forced value
G
dialog group
S
result group
T
result element
• These are the building
blocks of the dialog
• Prompts are the smallest
piece
• Prompts go on elements
• Elements go into dialogs or
they can go into groups
• Groups go in dialogs
D for dialogs
Always check
for where you
are
Check Status
Is it linked?
AD for adding
Look at the dialog
Look at the Progress Note Text
Clean it up –
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Delete items not needed
Edit what it says in the progress note
Add new elements if desired
Auto-generate does NOT make any groups. It
does make the elements
• You can choose to re-make the dialog and put
the elements into groups if desired
Display text and progress note text
• These two can be different
• The display text is what the person entering the note
sees
• Example:
DIALOG/PROGRESS NOTE TEXT:
Alcohol Screening - Enter results of the CAGE test
ALTERNATE PROGRESS NOTE TEXT:
CAGE test scores
Reminder Exchange Dialogs
• Dialogs entered through
reminder exchange are
inactive
• If the reminder has
been added to the EHR,
this message will
appear
Activate the dialog
• In RPMS, go to the list
of dialogs
• Choose the one you
wish to edit
• Review the dialog
• Choose ED to edit the
dialog
Edit the Dialog
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NAME: IHS-TOBACCO SCREEN//
DISABLE: DISABLED IN EXCHANGE Replace @
SURE YOU WANT TO DELETE? Y (Yes)
CLASS: LOCAL//
SPONSOR:
REVIEW DATE:
SOURCE REMINDER: TOBACCO TEST//
Select SEQUENCE: 20//
Edit a Dialog Element
• You can edit a dialog
element by choosing
the number from the
dialog screen
• Choices are
– E Edit dialog
– C Copy and replace
– D Delete element
Make a dialog from Scratch
• What do you need?
• Write it on paper first
• Work from the bottom up, prompts, elements,
groups, dialog
Dialog to Make
• Dialog closed
Groups Open Up
• Group contains
Elements
Fully Expanded
• Dialog after creation
• Groups
• Elements
– Education Topics
– Order
• Prompts
Prompts – the smallest level
• Those that start with
PXRM come with
reminders.
• All others are build from
those
• A prompt must be
attached to an element
AND the comments
prompt must also be
included
Prompts
• Select DIALOG to add: SIDE EFFECTS
• Are you adding 'SIDE EFFECTS' as a new REMINDER DIALOG (the 79TH)?
No// Y
• Prompt NAME: SIDE EFFECTS//
• DISABLE Prompt:
• CLASS: L LOCAL
• SPONSOR:
• REVIEW DATE:
• PROMPT CAPTION: Side Effects
• EXCLUDE FROM PROGRESS NOTE:
• DEFAULT VALUE:
• Select CHECKBOX SEQUENCE:
Elements – Where the work happens
• Naming Conventions
– ED Education topics
– HF Health Factors
– EX Exams
– IM Immunizations
– OI Orderables
– HD or TX for text only or headers
Elements – without PCC Data
• Select DIALOG to add: HD HTN TAKING MEDS
Are you adding 'HD HTN TAKING MEDS' as
a new REMINDER DIALOG (the 80TH)? No//
• DISABLE:
• CLASS: L LOCAL
• SPONSOR:
• REVIEW DATE:
• RESOLUTION TYPE:  Not doing PCC Data
• ORDERABLE ITEM:
• FINDING ITEM:  Not doing PCC Data
Elements – No PCC
• DIALOG/PROGRESS NOTE TEXT:
– Is patient taking medications as directed?
• ALTERNATE PROGRESS NOTE TEXT:
– Patient’s medication compliance
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EXCLUDE FROM PROGRESS NOTE:
SUPPRESS CHECKBOX:
Select ADDITIONAL FINDINGS:
RESULT GROUP/ELEMENT:
Select SEQUENCE:
Elements – Add Prompts
• Select SEQUENCE: 1
ADDITIONAL PROMPT/FORCED VALUE: SIDE EFFECTS
LOCAL
...OK? Yes// (Yes)
• OVERRIDE PROMPT CAPTION:
• START NEW LINE: 1 YES
• EXCLUDE FROM PN TEXT:
• REQUIRED:
• Select SEQUENCE: 10
ADDITIONAL PROMPT/FORCES VALUE: PXRM COMMENTS
OK? Yes//  Need this one for local prompts to appear
prompt
Element – Education Topic
• Select DIALOG to add: ED HTN MEDICATIONS
• Are you adding ‘ED HTN MEDICATIONS' as a new
REMINDER DIALOG (the 83TH)? No// YNAME: ED
HTN MEDICATIONS//
• DISABLE:
• CLASS: L
• SPONSOR:
• REVIEW DATE:
• RESOLUTION TYPE: DONE AT ENCOUNTER
Element – Education Topic
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ORDERABLE ITEM:
FINDING ITEM: ED.HTN-MHTN-MEDICATIONS HTN-MEDICATIONS HTN-M
...OK? Yes//
DIALOG/PROGRESS NOTE TEXT:
The patient is able to verbally summarize their medication regimen
and the importance of compliance with therapy.
Edit? NO//
ALTERNATE PROGRESS NOTE TEXT:
No existing text
Edit? NO//
EXCLUDE FROM PROGRESS NOTE:
SUPPRESS CHECKBOX:
Element – Education Topic
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Select ADDITIONAL FINDINGS:
RESULT GROUP/ELEMENT:
Select SEQUENCE: 1
ADDITIONAL PROMPT/FORCED VALUE: PXRM LEVEL
1 PXRM LEVEL OF SEVERITY
prompt NATIONAL
2 PXRM LEVEL OF UNDERSTANDING
prompt NATIONAL
CHOOSE 1-2: 2 PXRM LEVEL OF UNDERSTANDING prompt NATIONAL
OVERRIDE PROMPT CAPTION:
START NEW LINE: 1 YES
EXCLUDE FROM PN TEXT:
REQUIRED: 1 YES
Select SEQUENCE: 10
ADDITIONAL PROMPT/FORCED VALUE: PXRM COMMENT//
OVERRIDE PROMPT CAPTION: PXRM COMMENT//
START NEW LINE: Y YES
EXCLUDE FROM PN TEXT:
REQUIRED:
Element - Order
• Select DIALOG to add: OI HYPERTENSIVE MEDS
Are you adding 'OI HYPERTENSIVE MEDS' as
a new REMINDER DIALOG (the 84TH)? No//
• DISABLE:
• CLASS: LOCAL//
• SPONSOR:
• REVIEW DATE:
• RESOLUTION TYPE: ORDERED
...OK? Yes// Y (Yes)
• ORDERABLE ITEM:
• FINDING ITEM: Q.PSOZM HYPER PSOZM HYPERTENSION MEDS
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...OK? Yes//
Element - Order
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DIALOG/PROGRESS NOTE TEXT:
Check to order or change medications
Edit? NO//
ALTERNATE PROGRESS NOTE TEXT:
Medication change ordered
Edit? NO//
EXCLUDE FROM PROGRESS NOTE:
SUPPRESS CHECKBOX:
Select ADDITIONAL FINDINGS:
RESULT GROUP/ELEMENT:
Select SEQUENCE:
Input your edit comments.
Edit? NO//
Group – Makes it prettier
• A group allows you to put several elements
together. Groups can be hidden until clicked
so they act like templates
• Users may select 1 or more items in the group
Group
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Select Item: Quit// AD Add
Select DIALOG to add: GRP HTN LIFESTYLE CHANGES
Are you adding 'GRP HTN LIFESTYLE CHANGES' as
a new REMINDER DIALOG (the 97TH)? No// Y
NAME: GRP HTN LIFESTYLE CHANGES Replace
DISABLE:
CLASS: L
Groups
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SPONSOR:
REVIEW DATE:
RESOLUTION TYPE:  Would apply
ORDERABLE ITEM:  to entire group
FINDING ITEM: 
GROUP CAPTION:
PUT A BOX AROUND THE GROUP: y
Group
• SHARE COMMON PROMPTS: 0
• 1 yes
• 0 no
• MULTIPLE SELECTION: 2
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0 NO SELECTION REQUIRED
1 ONE SELECTION ONLY
2 ONE OR MORE SELECTIONS
3 NONE OR ONE SELECTION
• HIDE/SHOW GROUP: H
Groups
• GROUP HEADER DIALOG TEXT:
Check to document lifestyle changes discussed with patient
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Edit? NO//
GROUP HEADER ALTERNATE P/N TEXT:
The following lifestyle changes were discussed with the
patient/family:
Edit? NO//
EXCLUDE FROM PROGRESS NOTE:
SUPPRESS CHECKBOX:  If you want it mandatory
or for headers
NUMBER OF INDENTS: 2
Groups
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INDENT PROGRESS NOTE TEXT:y
Select ADDITIONAL FINDINGS:
Select SEQUENCE: 1
DIALOG ELEMENT: ED HTN-WEIGHT CONTROL
dialog element LOCAL
...OK? Yes//
EXCLUDE FROM PN TEXT:
• Select SEQUENCE: 2
……Continue to add elements to the group
Group view
Group – progress note text
Dialog – The upper level
• The dialog is now ready to be created
• Dialog can be made up of elements and/or
groups
Dialog
• Select Item: Quit// AD Add Reminder Dialog
• GENERATE DIALOG AUTOMATICALLY: Y// NO
• Select DIALOG to add: HTN INTERVENTION
Are you adding 'HTN INTERVENTION' as a new
REMINDER DIALOG (the 98TH)? No// y
• NAME: HTN INTERVENTION
• DISABLE:
• CLASS: l LOCAL
• SPONSOR:
Dialog
• REVIEW DATE:
• SOURCE REMINDER: HTN INTERVENTION
LOCAL
• Select SEQUENCE:
– Can enter the sequence number for what you
want on the dialog OR
Dialog
• Select the dialog
• Select Sequence: Quit//
5
• ARE YOU ADDING 5 AS
A NEW SEQUENCE
NUMBER: N// y YES
• Select new DIALOG
ELEMENT: GRP HTN LIFE
Dialog
• Puts it in
• Often leave spaces
between items for later
editions
• Easiest way to edit a
dialog
• Can edit, delete, copy
items
Finished dialog
Attaching to a Reminder
• A dialog made this way does not need to be
attached to a reminder
• It can be a dialog template to be used in notes
• If it has a source reminder, you must go back
to the reminder and attach it.
• Select CV to change view and go to R for
reminders
Attaching
• Choose LR to link
reminder
• LINKED REMINDER
DIALOG: HTN
INTERVENTION
reminder dialog
LOCAL
...OK? Yes//
Attaching
• How do you view this
reminder?
• Add it to the list for the
EHR and then test
• All changes must be
made in RPMS
• No editing in the GUI
Test the Dialog
• Add this reminder to list
• Start a note
• View the reminder
Test the dialog
• Make changes until it
looks the way you
desire
• Then make it available
for all needed clinicians
Test the dialog
• If you added
any orders, are
they working
correctly?
Making a Dialog TIU Template
• A dialog can be used as a note template
• Education dialogs are good examples since
you don’t always know when you are going to
do the education
• They are still made in RPMS but not attached
to a reminder
• When finished, they must be available to TIU
Attach to Parameter
• TIU TEMPLATE REMINDER DIALOGS may be set for the
following:
1
3
4
5
User
USR
Service
SRV
Division DIV
System
SYS
[choose from NEW PERSON]
[choose from SERVICE/SECTION]
[DEMO HOSPITAL]
[DEMO.CIAINFORMATICS.COM]
TIU TEMPLATE REMINDER DIALOG
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Enter selection: 5 System DEMO.CIAINFORMATICS.COM
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- Setting TIU TEMPLATE REMINDER DIALOGS for System:
DEMO.CIAINFORMATICS.COM Select Display Sequence: 1
Display Sequence: 1// 1
Clinical Reminder Dialog: TEST// TEST reminder dialog
...OK? Yes// (Yes)
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LOCAL
Select Display Sequence: 2
Are you adding 2 as a new Display Sequence? Yes// YES
Display Sequence: 2// 2
Clinical Reminder Dialog: HTN INTERVENTION
reminder dialog
...OK? Yes// (Yes)
LOCAL
EHR Template Editor
TIU Reminder Dialog
Make a new
template
New Type –
Reminder
Dialog
Reminder Templates
Attach it
to the
reminder
dialog
Reminder Templates
Its now
available in
the template
drawer
Reminder Templates
• These templates CANNOT be part of any other
TIU template
• If you add it as a “sub template”, TIU will skip
over it
• Questions