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Last Post by virtualHITman 9 years ago

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jomatejo

(@jomatejo)

Posts: 2

New Member

Topic starter

is it possible to start an office visit 1 day prior to the actual visit.

Error comes up when changing the clinical date stating can't be future date.

We want the visit date to reflect correctly and if we have any clinical changes it grey's out the field to change the clinical date the next day.

Any options?

Posted : March 25, 2016 6:43 am

mjharunk

(@mjharunk)

Posts: 191

Reputable Member

Not that I know of... What is the purpose of starting the visit 1 day early? You could create a "preload" encounter type to populate information ahead of time that could be retrieved during the visit.

Posted : March 25, 2016 6:52 am

acantu

(@acantu)

Posts: 722

Prominent Member

would have to write a script to change the date to a date ahead:

UPDATE DOCUMENT SET CLINICALDATE = CONVERT_DATE_TO_ID(TO_DATE(CONVERT_ID_TO_DATE(CLINICALDATE)) + 1) WHERE SDID = [INPUT SDID HERE]

just make sure you do it to the right SDID, Document. This will add 1 day to your clinical date.

Posted : March 25, 2016 7:22 am

jomatejo

(@jomatejo)

Posts: 2

New Member

Topic starter

Is it possible to use this script inside a quicktext?

if so what would the code be.

We have providers who like to prep orders, and part of the instructions to the patient.

Thanks again

Posted : March 26, 2016 10:14 am

acantu

(@acantu)

Posts: 722

Prominent Member

sorry, that is not possible, if you do not do scripting, another solution is building a custom add-on for you, so you can select the patient, document you want to add a day to, and process.

Posted : March 26, 2016 4:07 pm

virtualHITman

(@virtualhitman)

Posts: 319

Reputable Member

I suspect that the inability to create a note with a future encounter date is by design. Same applies for recording observations in advance and then trying to change the date of the document that recorded those observations. The purpose of this "feature" would be to maintain an accurate audit trail. Many EMRs have come under fire by CMS for allowing a "copy-forward" and/or "copy and paste" functionality. See referenced articles below:

http://www.medscape.com/viewarticle/817604 (this article requires a Medscape account)

Here's another one from AHIMA:

http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_038463.hcsp?dDocName=bok1_038463

While documenting in advance is not necessarily the same thing as "copy-forward", I suspect it would fall under the same scrutiny because you are documenting events that have not yet been observed. I'm not going to make any presumptions about your situation, but it is not uncommon for providers to want to set up their progress note prior to the visit to gain efficiency. The OIG frowns upon this behavior and providers that choose to document clinical list changes in advance of an actual office visit are opening themselves up to audit risk. If the provider is wanting to "preload" known historical data, then I would recommend using a "preload" encounter type as mjharunk suggested. Centricity provides a lot of features to assist the provider with efficient documentation (quick texts, standing orders, custom form development, etc.) but I would need to know more about your specific situation before I could make some suggestions. I would avoid using a custom SQL script to modify the date of the document. While that would technically work, you are basically bypassing the auditing system GE has programmed into their EMR. This could potentially cause issues down the road when performing upgrades, but minimally you would want to avoid the risk of having to explain why you bypassed an auditing control in Centricity. Trust me, I feel your pain as I have had my share of providers asking for the same thing. I know this doesn't offer a solution, but hopefully it will give you the ammunition needed to explain to your providers why documenting in advance is not a good idea.

Posted : March 28, 2016 2:49 am

Michelle

(@michelle)

Posts: 38

Eminent Member

Hi:

Our old EMR system allowed us to create the exam in advance. The purpose and efficiency of it is that the scribe can then concentrate on assisting the physician during the actual office visit rather than having to worry about creating the exam and entering the social/medical history. We have tried the preload document, but surprise, surprise, the data does not carry forward automatically to the exam so it has to be re-entered! And if the data does not appear on the exam then how does the doctor satisfy his CPT coding requirements?

I do not see any harm in allowing users to open a document 1 day in advance of the scheduled visit. Even if it is audited, the actual documentation of the exam is also recorded so the OIG can see when the doctor entered the information. Seems to me like it is just easier for them to not try to find the information and make an illogical ruling instead.

Michelle

Posted : May 12, 2016 7:16 am

virtualHITman

(@virtualhitman)

Posts: 319

Reputable Member

Michelle,

preloading data should be able to accommodate your needs but you may have to set up your own encounter forms. Previous observations can appear in a new encounter by using the OBSPREV function. GE has several form components that can insert prior values (previously observed values) like HPI into the note. If you have a specific need, I'd be happy to explore some options for you. What are you trying to preload that is not able to populate the encounter? Do you mind sharing what form components you're using for both preloading data and the actual encounter?

Posted : May 17, 2016 2:05 am

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