Brenda,
this would be a fun project. I'll offer you three strategies with pros/cons. All of these will require you to deduce the formulas for calculating the acceptable low and high range values over the term of the pregnancy. I used the website you provided and discovered the following:
For someone with normal BMI (based on weight prior to pregnancy)
0-2 weeks; no weight gain
2-14 wks; Low limit = 1 lb, High limit = 5 lbs
14-40 wks; Low limit = 25 lbs, High limit = 35 lbs
For someone with BMI classified as overweight
0-2 weeks; no weight gain
2-14 wks; Low limit = 1 lb, High limit = 5 lbs
14-40 wks; Low limit = 15 lbs, High limit = 25 lbs
Basically what this tells me is that the formulas are contingent upon the person's initial BMI. Once you have deduced the formulas for high and low range for each class of BMI, you could employ one of the following three strategies.
Use Flowsheet in CPS
You can use the flowsheet functionality in CPS to track values and graph them over time. Capturing the patient's weight throughout their pregnancy is no biggie. But to plot the low and high ranges will require some coding and prepopulating of the flowsheet. This would occur at the patient's first visit and require the following parameters (OBS terms):
Start date of pregnancy, end date of pregnancy, initial BMI, low range weight (e.g. custom OBS term), high range weight (e.g. custom OBS term)
Strategy: You could have a custom form that you might use during an office visit to capture the OBS terms above. You would then use a function (function would be called when you press a button) to populate the flowsheet with calculated values for each of the ranges (high and low) over the pregnancy term. You would need to calculate 4 separate points over the pregnancy term (calculations would be based on BMI classification; normal, overweight, etc.) for each reference range (high and low). Example using normal BMI patient. The first point would be dated with the pregnancy date and equate to their weight at that point in time. The second point would also equate to their initial weight but be dated 2 weeks after pregnancy date. The third point would be their initial weight + 1lb and 5lbs for low and high ranges respectively but dated 14 weeks after pregnancy date. The fourth point would be their initial weight + 25lbs and 35lbs for low and high ranges respectively but dated 40 weeks after pregnancy date. You could set up a flowsheet labeled "Pregnancy Weigh Tracker" or something like that and display the appropriate OBS terms (Weight, Low Range, High Range). That way you could plot all three lines on the graph and show the patient where they fell in relation to the acceptable ranges.
Technical Note: I have verified that it is possible to record Observation values on a future date
Pros: Solution is native to CPS; no other software is needed
Cons: Need to identify a couple of OBS terms to record low/high ranges (may have to request them from GE) and the patient will have Observations that appear to have been recorded in the future (might look funny to anyone viewing the All flowsheet)
Use Excel Spreadsheet
You could integrate an Excel spreadsheet into the patient's chart which would dynamically link to the data that was captured for the patient's pregnancy date and weight values over the term of the pregnancy (would pull all weight values captured between 0 and 40 weeks from pregnancy date). The Excel template would then plot these values on a chart which would display the low and high ranges based on patient's BMI.
Technical Note: Data could be rendered as an XML document and consumed by Excel during the visit or the Excel spreadsheet could run a stored procedure in your database when opened to dynamically pull the values needed to generate the graph. Excel document could be saved as a PDF and attached to office visit chart (there are ways to automate this).
Pros: Much prettier presentation than the CPS flowsheet. Document could be attached to office visit note and shared with patient via patient portal, faxed to another provider, etc.
Cons: Fair amount of technical knowledge to pull this off.
Use API to communicate with online pregnancy calculator
This approach assumes such a product exists. An application programming interface (API) might allow you to open up a web session (using a button on a custom form for example) and pass the data point needed to generate the graph from an online service.
Technical Note: Unaware of any pregnancy weight trackers that currently support this. Maybe I will develop one. 🙂
Pros: Much prettier presentation than the CPS flowsheet. Might be able to generate a static document (pdf format for example) that could be downloaded and attached to the chart note.
Cons: May not exist.
Posted : August 2, 2016 3:47 am
