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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 –
• 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• 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
• 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 prompt
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 COMMENTSOK? Yes// Need this one for local prompts to appear
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• 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• 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• ...OK? Yes//
Element - Order• 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• 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
• 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 • 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 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• 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 User USR [choose from NEW PERSON] 3 Service SRV [choose from SERVICE/SECTION] 4 Division DIV [DEMO HOSPITAL] 5 System SYS [DEMO.CIAINFORMATICS.COM]
TIU TEMPLATE REMINDER DIALOG• Enter selection: 5 System DEMO.CIAINFORMATICS.COM • - 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 LOCAL ...OK? Yes// (Yes) • 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 LOCAL ...OK? Yes// (Yes)
EHR Template Editor
TIU Reminder Dialog
New Type – Reminder Dialog
Make a new template
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
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