Error Messages and PowerNotes

We are on a long and winding road to perfect documentation. I don't know about you, but I don't know when we'll get there. It's hard work. I'm guessing I've done around 10,000 PowerNotes over the last few years, between office visits, hospital progress notes and correspondence letters. And while it helps to be able to touch type and even more to be able to type about one thing and talk with a patient about another at the same time, it can be stressful stuff. Structured templates, by their nature, rely on two hands, two eyes and two ears, and are necessarily labor intensive.

I can talk about a host of efficiencies that make PowerNotes more manageable until I'm hoarse (and some of you have heard me), but today I'd rather share my sympathy and be a compassionate provider of transparent informatics.

I know from my own experiences, and from your calls, that there is NOTHING MORE FRUSTRATING than getting an error message that freezes the screen or boots you offline. I received a call earlier today from a colleague who reported just this. Fortunately, the two of us had spoken before about this problem and I was able to take a look at the particular patient record.

Many folks know from prior communications that, if you Select All and Insert Selected when entering lab data into a PowerNote, an insufficient memory error fires. In today's case, though, this was not the cause. It happens that the clinician entered the medication profile twice: once when reviewing & reconciling in the beginning of the note and again at the bottom to document modifications to the list. I can't say whether this alone created the problem, though I've got to think it contributed. What I am pretty certain about is that the default display preferences had a detrimental effect. Between loading the list twice and the defaulted over-display of partially useless information, the error message was bound to occur.

Take a look at the slides to see what I mean and how to change your medication profile preferences.


Uploaded on authorSTREAM by nrk99

Take home messages:

1. I hope I helped someone out today.
   
2. If you ever have a CIS technical issue, grab as much related information as possible, i. e. patient name, MRN, document name/type, time/date, and send it to me, Tom or Pat, or call the Help Desk.
3. Avoid using Select All followed by Include all, particularly when entering lab data.
4. Enter the medication profile one time only; if you want to document that you have reconciled the medication list (which you always should) in the midst of the note, select Medication Profile Reviewed. I have discussed this method of documentation with the PBO and have verified that this is as kosher as the full list with regard to billing code status. Feel free to add the medication list at the bottom after modification.
   
5. Change the Preferences in the Medication Profile list. It is cleaner and much easier to read and interpret.