WELFORD CHART NOTES
NEWSLETTER
Volume 21, No. 3 September, 2002
copyright 2002, Welford Medical Computing, Inc. All rights reserved
USING MEDICATION TEST REMINDERS (User's Manual, pgs. 739-749)
One of the most powerful new features in version 4.2 is Medication Test Reminders. These remind you to perform tests at regular intervals when patients are taking medications. The program comes with over 1500 of these reminders which you are free to edit, and you can add as many more reminders as you like. Reminders can have a number of purposes, such as:
·
checking the blood level of the drug to look for toxicity, inappropriate dosing, or noncompliance (e.g. digoxin level);·
checking renal or liver function when the drug is excreted renally or metabolized by the liver to determine whether the dose needs to be changed (e.g. vancomycin);·
watching for possible adverse effects of the drug on target organs (e.g. amiodarone harming the lungs or thyroid, antineoplastic drugs suppressing the bone marrow).In this and subsequent newsletters, we will see how to look up these reminders, how to be automatically notified when there are relevant reminders, and how to write your own reminders as well as editing or skipping the ones that come with the program.
LOOKING UP REMINDERS FOR A PATIENT'S MEDICATION
Suppose you would like to see what reminders are in the system for metformin, which Kelly Erickson is taking:1. Press Write\Medications and enter KELLY ERICKSON as the patient's name.
2. On the patient's medication list, highlight metformin.
3. Press Utility\Test Reminders\Look up this drug.
4. You now see a list of the Medication Test Reminders for metformin.
5. Suppose you want to see why you should check BUN or creatinine yearly. Double-click on that entry, or else highlight it and press Edit.
Let's check Kelly's medications to see if any tests are due:
1. Press Write\Medications and enter KELLY ERICKSON as the patient's name.
2. If you are only interested in one particular medication, highlight that and press Utility\Test Reminders\Check this drug. However, in most situations, you will care about all of the drugs the patient is currently taking, so instead choose All drugs check.
4. Notice that the list consists of a series of check boxes. If you uncheck the name of a drug, all of the tests beneath that drug are unchecked automatically. (You might decide to do this if you know you will soon be stopping that drug).
5. Notice that each test line tells you the name of the test, how often it is supposed to be done, when it was last done, how serious the warning is, and whether the warning comes from the Program or was written by you.
6. You can see the detailed explanation of any line by double-clicking it or by pressing Edit (and can even change the reminder at that time if you wish by editing it).
7. You can choose which tests on the list you agree need to be ordered at this time (by keeping check marks in front of them) and then press Order them to have them automatically recorded in the Orders Utility as new orders for your staff to implement.
8. If you want to look at other portions of the patient's chart before deciding which ones to order, press the GoTo button and choose which chart function you wish to use.
9. If there is a reminder on the list that you completely disagree with and know you never want to see again for any patient as a reminder, press the Skip button. This is not the same as simply skipping ordering this particular test on this particular patient at this particular time. For example, if the program recommends that you check serum potassium periodically in patients taking NSAIDs (which is an actual manufacturer's recommendation, but of mild severity, and one which is not widely practiced), but you don't agree that this needs to ever be done routinely on anyone, you can highlight that reminder and press Skip. However, if you agree with the reminder in general but disagree with one of its particulars (for example, you want to be reminded to do it once a year instead of every 6 months), you should instead press Edit (or double-click it) to open the Medication Test Reminder Editor for this reminder, then change the aspects of it you want changed to your own preference, then press Ok to store the reminder.
(10. If you happen to press Skip by accident or later change your mind, you can also unskip it by pressing Libraries\Medication Test Reminders\Show Skipped\Unskip.)
11. If you find the program is reminding you about many reminders that you consider too trivial, instead of editing or skipping all of them, consider pressing the Options button from this reminder list (or from Libraries\Medication Test Reminders\Options) and setting Show reminders having a Severity of to a higher level. Reminder, however, that if you set it to a higher level, you may end up not seeing reminders of a lower level that you otherwise might wish to have seen.
We'll cover more about Medication Test Reminders in the next newsletter.
SEND US YOUR TIPS If you have tips, shortcuts, questions, 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