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Templating

Templating. by Stephen Z. Fadem, M.D., FACP, FASN. Clinical Professor of Medicine Baylor College of Medicine Houston, Texas. Now what…. You carefully analyzed your office needs Submitted an RFP Negotiated the contract Purchased the hardware, installed the network and then the software

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Templating

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  1. Templating by Stephen Z. Fadem, M.D., FACP, FASN Clinical Professor of Medicine Baylor College of Medicine Houston, Texas

  2. Now what…. • You carefully analyzed your office needs • Submitted an RFP • Negotiated the contract • Purchased the hardware, installed the network and then the software • They have tested it and trained your staff • You are in the process of implementing it • and……

  3. It is time to tailor the system to your personal needs • This section is about templating • You can customize parts of your program • This is important because… Good templates • Smooth workflow • Saves time • Reduces errors

  4. Tailoring - Like a fitting • Template - Interact with database • No two doctors work the same way • Templates help doctors manage patients • They help the administrators manage and analyze the practice

  5. First some background Anatomy of the Database DATA IN DATA OUT STORE DATA

  6. Dictation Another computer Voice Recognition Keyboard MONITOR FILE PRINT E-MAIL DATA IN DATA OUT STORE DATA MACHINE READABLE MATERIAL STORED IN CONNECTING (RELATED) TABLES CREATED, READ, UPDATED OR DELETED (CRUD)

  7. Essentially, it is a form

  8. Paper form used by Kidney Associates to document dialysis visits

  9. Who builds the template? EMPLOYEE YOU COMPANY

  10. Plan form to follow function and workflow

  11. Link to web resource mdrd.com Can select diag- nostic & therapeutic options for CKD 1+ Classify by stage Modality choice Buttons to other templates Action plan by stage Anatomy of a template form - CKD

  12. After designing the form, it can be saved and either used or quickly changed again.

  13. Templates must be modifiable

  14. They are not set in stone • Not set in stone • Avoid Macromedia Flash • Use design object oriented, popular design tools • Modifiable within a few minutes • Scalable - move quickly across the Enterprise

  15. Template relations • Relate to a large database of medical standards • Medcin • Relate to laboratory/Imaging • The template must be able to access fields in your lab data - NPI, ID patient, lab definition, date • Relate to your Practice management software • Images, demographics, medications, vital signs • Relate to the patient’s central record or PHR

  16. HPI Allows free text. Boxes assure completeness

  17. Common diagnoses are listed. The browse feature allows access to others.

  18. Form includes Common treatment options

  19. Buttons link to additional forms for each CKD component

  20. Completed form for CKD

  21. Templating Practice Analytics • Database reports • Demographics • Filters • Diagnoses • Labs • Assist in marketing, trend analysis, planning • Extra cost for application from some vendors

  22. Example: Using a template to capture dialysis billing

  23. Drag and Drop file into right box in order you want reported. Will sort ascending if box is checked COMMENTS  HOSP  Number Visits  Practice ID  Health Plan  Vascular surg  Guest  Shift day  Shift time  Location  Name  Age  ZIP  FDOD  Report name____________________

  24. The Future: From paper to algorithm to system

  25. Efficient Test against IOM's six dimensions of quality care Equitable Safety Effective Patient Centered Timely Corrigan, JM.;Donaldson, MS.;Kohn, LT.;Maguire, SK.; Pike, KC. Crossing the Quality Chasm. A New Health System for the 21st Century. Washington, DC: Institute of Medicine, National Academy of Sciences, National Academy Press; 2001.

  26. Measures • Timeliness - Does the form improve patient access, cut waiting time, move data quickly? • Patient centered - Spend more time, understand, explain, show empathy and respect • Effectiveness - Will it facilitate practicing evidence based medicine? • Patient safety - improve workflow and information exchange, reduce distraction, improve volume • Equity - Expand access to service • Efficiency • Technical - increase functionality through technology • Productive - improve operations and increase value/time • Allocative - can reassign resources doing duplicative tasks

  27. Take home messages • The template is a form structure that you or your staff modify to increase the value quality of your practice, efficiency and effectiveness of your service. • The form must follow your workflow, be easily modifiable, and will be changed frequently as you discover better ways to handle your patients.

  28. THE END

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