In CPS 12, our clinical staff would like to prep the office visit document the night before in preparing for patients and would need to change the clinical date to the future but are unable to. Unable to find a setting to allow this in administration or security permissions. Is this a regulatory requirement that prevents it or is there somewhere to allow this in Centricity?
You can open a visit in the future, but the only way you can change the clinical date the day of the visit is, if there were no signed clinical list changes within that prep of the visit. I hope this makes sense.
The short answer to your question is yes. While you won't find a regulation that states "an EMR shall not allow a user the ability to create a note with a clinical date in advance of the encounter date", EMR vendors have come under fire for allowing behaviors in their applications that might jeopardize the integrity of the note. I have responded to questions like this in the past and to preempt any arguments, it is simply not best practice to document or "prepare a note" in advance of a visit. AHIMA has a pretty good article on this if you find yourself having to explain it to your providers:
http://library.ahima.org/doc?oid=300257#.WFHBdFXruUk
I totally get that a provider wants to be productive and can argue that "preparing the note in advance" allows them to spend more quality time with the patient. However, that argument is not going to fly if you were to ever get audited. Audit trails are also being captured to provide traceability, so even if Centricity allowed one to do it, I would not want to have to defend an audit trail that showed I had documented things prior to the actual clinical date. Again, I suspect some will argue that the provider ultimately validates the accuracy of the data when they sign off on the note, so why does it matter? You may have one of the most detail oriented providers, but auditors will tell you that they have seen far more abuse and errors propagated by these behaviors.
Hope that helps.
Thank you for the detailed information! We will be sure to let our providers no the implications of doing the prep the day before.
if you are just trying to open the documents, each appointment type allows for one document to be opened when the appointment is arrived. We just do that.
Thank you Sibylle for this answer! I'll be talking with my director and compliance officer to see if we should actually offer this is as a workflow option for clinical staff in light of virtualHITman's response.
You are welcome. I know how frustrating this can be to providers, but in the end, you are really looking after their best interests. On a positive note, I do believe GE is moving in a direction (like other vendors) that should make their EMR more usable and more interoperable.
I actually made a program to allow you to change the visit date to a future date after it is initially created.
In our old EMR system we used to be able to prep the exam the night before. This made things so much easier, enabled more accuracy with the data being entered, and created a smooth workflow the next day for the physician. Now the physician has to wait for the scribe to open the exam and then populate the required patient history. Very inefficient.
We tried to create exams in advance when we first moved to Centricity EMR and received an error box that stated we were not allowed to enter a date in the future. For anyone that currently does this, I would like to know what version of Centricity you are running, because it does not allow you to do it on Version 12.0.10.
Thanks.
Michelle Carabin
Professional Orthopaedic Associates
It really depends on the type of forms you have in your encounters. I would test it on a test patient. Open a visit with a future date. Make some of your prep entries, put the visit on hold. Right click on the visit and go to Change Properties, see if the clinical date is greyed out. If it is, it won't work this way. If it isn't, you should be able to ....
you are right, you can't put in the future date, so use today's date when you first open the visit. The day of the visit, change properties and then change your date. This process only works if you don't submit the charges through that visit. If you do put charges in through that visit, you can't open the visit on a different day, as it won't be associated correctly to the ticket in billing.
Hi for the person who said the wrote code to change the visit date, can you share the code?
post acantu date 12/14/21016
"I actually made a program to allow you to change the visit date to a future date after it is initially created."
Hi for the person who said the wrote code to change the visit date, can you share the code?
post acantu date 12/14/21016
"I actually made a program to allow you to change the visit date to a future date after it is initially created."
You can find the program in the CHUG MarketPlace
http://marketplace.centricityusers.com/#/shop/applications/
its called Clinical Date Changer Form and there is a version for both CEMR and CPS