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Help With Letter to Referring Physician

MEL, SQL, Oracle

Last Post by Anonymous 1 second ago

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mcbmd

(@mcbmd)

Posts: 9

Active Member

Topic starter

Just a preface, I have very little coding knowledge.

We are trying to create a letter to referring providers that will pull out only certain parts of the note. I have everything like I want it, except my HPI. It is broken down into different tabs that contain a combination of check boxes and text fields. I have the letter written to include each tab, but I get something that looks like this for each one.

yes^^chest congestion, shortness of breath, wheezing^^moderate^school age^none^1-

2x/week^no^^^^^^^^^^^^^no^^no^^yes^twice^Spring, Fall^^exercise, smoke/perfumes/strong

odors, colds or infections, dogs, cats^dust, cut grass, weather changes^^Pt. currently taking

Symbicort 160mcg daily inhaler 2 puffs twice daily (started ~2 weeks ago) and ProAir rescue

inhaler which he uses before exercise and as needed. Prior to two weeks ago, he was just on

PRN albuterol. Pt. is currently on Clarithromycin for "bronchitis" and has 7 days left on the

antibiotic and reports an increase in use of rescue inhaler since he has had infection^no^^^^^^

Also there are a bunch of "no^^^^^" if the patient denies symptoms under that particular heading. Here is how my letter is formatted in the HPI section (with each line being a different tab that is used on our form):

History of Present Illness:

{(OBSPREV("ASTHSTURI"))}

{(OBSPREV("PULMON HPI"))}

{(OBSPREV("URTICARCHRHX"))}

{(OBSPREV("HPI-HEADACHE"))}

{(OBSPREV("DERMATOPIC"))}

{(OBSPREV("ANAPHYLAXHX"))}

{(OBSPREV("GERD"))}

{(OBSPREV("PMH ADVR RXN"))}

{(OBSPREV("FD AL HX08C"))}

{(OBSPREV("STINSRXN09C"))}

Any help would be greatly appreciated

Posted : December 17, 2015 7:57 am

dcarpenter

(@dcarpenter)

Posts: 323

Reputable Member

Can I ask what form you are using to capture HPI? it looks like the information that your form is pushing into the Obs terms is being seperated by the caret symbol "^" to break up the information. I am using the CCC HPI form and our HPI is usually a free-text field where the provider can document however they like. There is a codding solution to remove the excess carets and format this , but I would love to see some screenshots of what the form and the text translation looks like. if it is a self built form, a change to the form would make the HPI more readable.

Thank you,

Daniel Carpenter

Posted : December 17, 2015 2:10 pm

mcbmd

(@mcbmd)

Posts: 9

Active Member

Topic starter

Hope I did this right. Added screenshots from our form and also what is translated from the form onto the clinic note.

HAACExample

Posted : December 21, 2015 10:52 am

mcbmd

(@mcbmd)

Posts: 9

Active Member

Topic starter

OK trying this a different way, because I don't know if I added the attachment right the first time.

HAACExample

Posted : December 21, 2015 10:53 am

mcbmd

(@mcbmd)

Posts: 9

Active Member

Topic starter

Daniel,
I had totally forgotten about this question. I appreciate you writing me back. To recap, what we would like to do is pull out the relevant portions of the HPI (not the one's that the patient doesn't endorse problems with), Testing (PFTs and allergy testing), and A&P to send to the referring physician. Right now our system is sending everything to the PCP, including our billing info, which I definitely don't like. I was trying to initially build a letter that would do that, but as you see I ran into difficulty.

Our document template consists of the following components

[MLI_FORM:Enterprise\Virtual Officeware\Allergy\HPI-Allergy]
[MLI_FORM:Enterprise\Virtual Officeware\Allergy\Hx Summary-allergy focus]
[MLI_FORM:Enterprise\CCC\Risk Factors-CCC]
[MLI_FORM:Enterprise\CCC\PMH-PSH-CCC]
[MLI_FORM:Enterprise\CCC\FH-SH-CCC]

[MLI_FORM:Enterprise\CCC\Vital Signs-CCC]
[MLI_FORM:Enterprise\General\Other\Med-Allergy Review]
[MLI_FORM:Enterprise\Rosch\Launch Rosch]
[MLI_FORM:Enterprise\CCC\PE-CCC]
[MLI_FORM:Enterprise\Hed-Allergy Testing]
[MLI_FORM:Enterprise\Virtual Officeware\Allergy\Results PFTs/Challenges]
[MLI_FORM:Enterprise\A&P Assessment and Plan]
[MLI_FORM:Enterprise\Virtual Officeware\Allergy\Allergy IT Reaction]
[MLI_FORM:Enterprise\CCC\Patient Instructions-CCC]
[MLI_FORM:Enterprise\Medicalogic\Prescriptions]
[MLI_FORM:Enterprise\Lab Tests\Process Lab Orders]]

Posted : January 19, 2017 5:58 am

dcarpenter

(@dcarpenter)

Posts: 323

Reputable Member

Ah very good! thank you so much for the screenshots and the further details. I think I understand how this form is working now, which will make grabbing the info from each section easier.

generally speaking, it appears that each piece of the HPI-Allergy form that you are using is recording data, and then it combines every item on the page with a "^" symbol before shoving the whole thing into the Observation term. They must have some background code to interpret this into a nice looking text translation, but it makes for a rather wierd looking obs term.

for your letter, you will want to include a MEL function at the top that can translate out each of these obs terms into a more readable format. here is a example of the code I would make:

{fn caretSlicer(obsname){
formattedStr = ""
if OBSPREV(obsname) <> "" then
obsArray = getfield(OBSPREV(obsname),"^","")
if obsArray[1] <> "no" then
for c=1, c < (size(obsArray) - 1), c = c+1 do
formattedStr = formattedStr + obsArray[c] + HRET
endfor
endif
endif
return formattedStr
}}

in the letter, instead of putting OBSPREV{("ASTHSTURI")}, you would put {caretSlicer("ASTHSTURI")}

Because each page is different though, we may want to hop onto a webex and look at what items specifically the letter should grab. You could also do a test patient with only the items that should be in the letter, and how you would like it formatted, and if you need help programming the code to pull that info, I would be glad to help.

please let me know if you have any questions.

Daniel Carpenter

Posted : January 19, 2017 11:49 am

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