MA MA Documents: BP- lying, sitting, standing (Prompts for out of Range) Weight, 180 Pulse- oral, radial, pedal, femoral Height, 5’9” Temperature- Fahrenheit, Celsius BP, 180/95 Height-feet/inches, centimeters Pulse, 89 Calculates and displays BMI Temp, 97.6F Allergy documentation food, drug, environment – How are medications updated? MA Reviews: Allergies, Penicillin>urticara Medication List, HCTZ 12.5mg.qid, Lopressor 100mg bid, Prevacid 30mg hs, Metformin 500mg bid MA MA Reviews: Content specific to each Hx item PMH Diabetes, Type II, Hypertension, GERD Ease of documenting year and relationship to patient – Surg/Hosp Hx pneumonia 1998 PQRI prompt for smoking status –hospitalized Family Hx mother L & W, father dec. CHF – 3 children normal vag. Deliveries Social Hx nonsmoker, retired – Immunizations Tetanus 98, flu 10/04 – Pneumovax 99 Advanced Directive signed 1/3/02 – Preventative Care mammogram 99 – MA completes Physician Physician is prompted that patient is ready Physician prompt easily identified Identify correct patients chart Patients chart/ medical Hx easily accessible Physician Physician looks at CC, PMH and past visit complaint entered by MA visible/can it be edited Option to default PMH into note Ease of viewing past visit Alerts reminders when a note is opened Physician Physician opens new note Follow up diabetes, hypertension, and documents HPI GERD. Patient states experiencing elevated fasting blood sugar at home.
MA MA Documents: Weight, 180 Height, 5’9” BP, 180/95 Pulse, 89 Temp, 97.6F MA Reviews: Allergies, Penicillin>urticara Medication List, HCTZ 12.5mg.qid, Lopressor 100mg bid, Prevacid 30mg hs, Metformin 500mg bid BP- lying, sitting, standing (Prompts for out of Range) Pulse- oral, radial, pedal, femoral Temperature- Fahrenheit, Celsius Height-feet/inches, centimeters Calculates and displays BMI Allergy documentation – food, drug, environment How are medications updated? MA MA Reviews: PMH – Diabetes, Type II, Hypertension, GERD Surg/Hosp Hx –hospitalized pneumonia 1998 Family Hx – mother L & W, father dec. CHF 3 children normal vag. Deliveries Social Hx – nonsmoker, retired Immunizations – Tetanus 98, flu 10/04 Pneumovax 99 Advanced Directive – signed 1/3/02 Preventative Care – mammogram 99 MA completes Content specific to each Hx item Ease of documenting year and relationship to patient PQRI prompt for smoking status Physician Physician is prompted that patient is ready Physician prompt easily identified Identify correct patients chart Patients chart/ medical Hx easily accessible Physician Physician looks at CC, PMH and past visit complaint entered by MA visible/can it be edited Option to default PMH into note Ease of viewing past visit Alerts reminders when a note is opened Physician Physician opens new note and documents HPI Follow up diabetes, hypertension, GERD. Patient states experiencing elevated fasting blood sugar at home.
nlc-ehr-demonstration-scenario-evaluation-vendor-questions.docx