WELFORD CHART NOTES
NEWSLETTER
Volume 25, No. 2 August, 2004
copyright 2004, Welford Medical Computing, Inc. All rights reserved
CREATING YOUR OWN FLOWSHEETS (User's Manual, pgs. 855-857)
One of the most powerful new features in version 4.6 is the Flowsheet. You can create Flowsheets to perform all sorts of useful functions. Some of the most common uses are to track drug doses and test results for patients with certain conditions, such as diabetes, hyperlipidemia, and use of warfarin. However, you can adapt them to all sorts of other purposes, such as following renal function in renal patients, blood counts in patients on chemotherapy, thyroid tests in thyroid patients, etc.
Let's set up a flowsheet to track thyroid patients:
1. Press View\Flowsheets\Edit.
2. For Title, type in Thyroid.
3. Click on the Test to add or change box. Here is where we add the names of tests that we want to monitor in our patients. Type in TSH and press Add. Note that you must press the Add button to add it to the list of Tests.
4. Now type T4 in the Test to add or change box and press Add.
5. You could continue adding tests here up to 10 tests. Please note that version 4.6 only supports numeric tests (as defined in the Lab Book Vocabulary). You can enter non-numeric tests, but they won't be recorded properly in the Lab Book off the Flowsheet. This has been remedied in version 4.7. If you need to use Flowsheets that track non-numeric tests, contact MEDCOM Information Systems for a 4.7 beta version that supports these tests.
6. Now move to the Drug or class name to add or change box. This is where we add the names of the drugs whose doses we wish to monitor in the Flowsheet. Type in THYROIDHORMONES and press Add. (You could add other drugs here as well, such as METHIMAZOLE and PROPYLTHIOURACIL if you want to track these doses as well). Note that you can add up to 20 names of drugs or drug classes. (Using class names is usually quicker and easier).
7. Click on the Assessment to add or change box. Here you want to type in the most common assessments that you might tell your patient about his or her test results. So, type in "doing fine", and press Add, then "on too little medication" and press Add, and then "on too much medication" and press Add. You can have up to 8 items on this list. (When actually using the Flowsheet, you can also type in any free text you want; you are not limited to just these 8 statements. It's just easier to use the 8 statements, because all you have to do is check them). The statements needn't be mutually exclusive; you can check multiple statements when using the Flowsheet.
8. Click on the Advice to add or change box. Here is where you list the most common advice you are going to be giving to patients, outside of actually changing the dose of a medication listed in the Medications list. Again, the statements don't need to be mutually exclusive, and users of the Flowsheet can type in free text when using the Flowsheet, in addition to selecting from the list of Advice. You can have up to 8 items of Advice. Type in "stay on the same dose" and press Add; then "increase your dose" and press Add; and finally type in "decrease your dose" and press Add.
9. The Next Tests are the tests you want the patients to have at some future date to monitor their progress. Since the Next Tests are usually the same as the Tests, you can simply press Copy to copy the list over. If there are some other tests you want to include on this list, you can add them as well. You can have up to 10 tests on this list.
10. The Repeat In interval is the most common interval of time at which you want most patients to have the Next Tests. So, if your custom is to measure thyroid function tests every 6 months in patients with thyroid disease (assuming the tests are normal and no extra tests are needed), then set Repeat In to 6 months. (Again, the user will be able to change this to any suitable interval; this merely supplies a default interval, so that most of the time, you can have it filled in automatically and won't need to change it).
11. Since you want to use all of these columns, check all 4 Include options.
12. Now, press Ok to store your Flowsheet.
HELP! MY COMPUTER CRASHED RIGHT IN THE MIDDLE OF WRITING A NOTE!
Although computers and operating systems are becoming less prone to crashing and freezing than in the past, they still do occasionally do so. Many users don't realize that Welford Chart Notes saves your note in the Writer in the background constantly as you write it. Thus, if the computer crashes or freezes on you in the middle of writing a note in the Writer, you can easily retrieve your note, instead of having to write it all over again. (This feature has been in the program for many years but we decided to highlight it again for users who didn't realize it existed --- User's Manual, pg. 157). The feature is called AutoSave, and it is controlled by setting System\Writer Options\Autosave Level to a number other than 0. (The factory default is 50, but you will probably want to set it to a much lower number, such as 10). The program stores the contents of the Writer to an Autosave file after every Autosave Level number of keystrokes; so, if you set it to 10, the most you will lose is your last 10 characters of the document. If the computer crashes or freezes in the middle of your note, after you reboot your computer and restart Welford Chart Notes, simply do the following steps:1. Press Write\New Note, and select the document type you were using (e.g. Note).
2. Enter the name of the patient you were editing.
3. Select no Template for the document. (Press Cancel or <ESC> when asked which one to use).
3. Before you do anything else, once you are inside the Writer, before you type any keystrokes, press <Alt-X>pander\Autosave and press PLAYBACK. The note you were writing will magically reappear inside the Writer!
NEWS ON UPCOMING VERSIONS
We are hard at work designing version 4.7, and have already started adding some features for it. If you have any features you would like to see in version 4.7, please let us know.SEND US YOUR TIPS
If you have tips, shortcuts, guestions, or suggestions for future newsletter topics, please send them to us at:Welford Medical Computing, Inc.
3779 Hermitage Trail
Rockford, IL 61114
or
MEDCOM Information Systems, Inc.
2117 Stonington Avenue
Hoffman Estates, IL 60195
http://medcom@emirj.com