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Reminder Dialogs. Introduction. Reminder Dialogs allow a user to resolve the reminder by entering data into the progress note and PCC Saves a step and user does not need to do any typing Dialogs can be turned into templates to be used on the notes tab. Introduction.

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introduction
Introduction
  • Reminder Dialogs allow a user to resolve the reminder by entering data into the progress note and PCC
  • Saves a step and user does not need to do any typing
  • Dialogs can be turned into templates to be used on the notes tab
introduction1
Introduction
  • Dialogs are usually a resolution to a reminder – i.e. documentation of a diabetic foot exam
  • However, they may be used to enter PCC data even if there isn’t a reminder, as in patient education
what is a dialog
What is a dialog?
  • Way to record data in PCC and in progress note
  • Looks like TIU template
what is a dialog1
What is a dialog?
  • One click can open up other choices
  • Can use check boxes or radio buttons
  • As the user opens up a box, data goes into the progress note and/or PCC
what is a dialog2
What is a dialog?
  • Prompts for comments can be added
  • Health factor of PREVIOUS SMOKER was added to PCC
  • Progress note is being created
what is a dialog3
What is a dialog?
  • Education topics can be addressed
  • Prompt for level of understanding
what is a dialog4
What is a dialog?
  • When finished is clicked, the data is inserted into the progress note
  • The data that went to PCC is visible at the bottom
pcc data
PCC Data

Data went to PCC and is on the wellness tab

3 ways to get a dialog
3 ways to get a dialog
  • Import one through Reminder Exchange
  • Auto-generate one after a reminder is created
  • Create one from scratch making each piece
dialog menus
Dialog Menus
  • Start out on the main Reminder Manager Menu
  • Menu is DM Reminder Dialog Management
slide12

Only 2 options

  • Dialog Parameters
  • Reminder Dialogs
di reminder dialogs
DI- Reminder Dialogs
  • Opens up to the reminders View
  • Use CV to see the other items
dialog pieces
Dialog Pieces

Choose from:

P prompt

E dialog element

R reminder dialog

F forced value

G dialog group

S result group

T result element

  • These are the building blocks of the dialog
  • Prompts are the smallest piece
  • Prompts go on elements
  • Elements go into dialogs or they can go into groups
  • Groups go in dialogs
d for dialogs
D for dialogs

Always check for where you are

Check Status

Is it linked?

AD for adding

clean it up
Clean it up –
  • Delete items not needed
  • Edit what it says in the progress note
  • Add new elements if desired
  • Auto-generate does NOT make any groups. It does make the elements
  • You can choose to re-make the dialog and put the elements into groups if desired
display text and progress note text
Display text and progress note text
  • These two can be different
  • The display text is what the person entering the note sees
  • Example:

DIALOG/PROGRESS NOTE TEXT:

Alcohol Screening - Enter results of the CAGE test

ALTERNATE PROGRESS NOTE TEXT:

CAGE test scores

reminder exchange dialogs
Reminder Exchange Dialogs
  • Dialogs entered through reminder exchange are inactive
  • If the reminder has been added to the EHR, this message will appear
activate the dialog
Activate the dialog
  • In RPMS, go to the list of dialogs
  • Choose the one you wish to edit
slide22

Review the dialog

  • Choose ED to edit the dialog
edit the dialog
Edit the Dialog
  • NAME: IHS-TOBACCO SCREEN//
  • DISABLE: DISABLED IN EXCHANGE Replace @
  • SURE YOU WANT TO DELETE? Y (Yes)
  • CLASS: LOCAL//
  • SPONSOR:
  • REVIEW DATE:
  • SOURCE REMINDER: TOBACCO TEST//
  • Select SEQUENCE: 20//
edit a dialog element
Edit a Dialog Element
  • You can edit a dialog element by choosing the number from the dialog screen
  • Choices are
    • E Edit dialog
    • C Copy and replace
    • D Delete element
make a dialog from scratch
Make a dialog from Scratch
  • What do you need?
  • Write it on paper first
  • Work from the bottom up, prompts, elements, groups, dialog
dialog to make
Dialog to Make
  • Dialog closed
groups open up
Groups Open Up
  • Group contains Elements
fully expanded
Fully Expanded
  • Dialog after creation
  • Groups
  • Elements
    • Education Topics
    • Order
  • Prompts
prompts the smallest level
Prompts – the smallest level
  • Those that start with PXRM come with reminders.
  • All others are build from those
  • A prompt must be attached to an element AND the comments prompt must also be included
prompts
Prompts
  • Select DIALOG to add: SIDE EFFECTS
  • Are you adding \'SIDE EFFECTS\' as a new REMINDER DIALOG (the 79TH)? No// Y
  • Prompt NAME: SIDE EFFECTS//
  • DISABLE Prompt:
  • CLASS: L LOCAL
  • SPONSOR:
  • REVIEW DATE:
  • PROMPT CAPTION: Side Effects
  • EXCLUDE FROM PROGRESS NOTE:
  • DEFAULT VALUE:
  • Select CHECKBOX SEQUENCE:
elements where the work happens
Elements – Where the work happens
  • Naming Conventions
    • ED Education topics
    • HF Health Factors
    • EX Exams
    • IM Immunizations
    • OI Orderables
    • HD or TX for text only or headers
elements without pcc data
Elements – without PCC Data
  • Select DIALOG to add: HD HTN TAKING MEDS

Are you adding \'HD HTN TAKING MEDS\' as

a new REMINDER DIALOG (the 80TH)? No//

  • DISABLE:
  • CLASS: L LOCAL
  • SPONSOR:
  • REVIEW DATE:
  • RESOLUTION TYPE:  Not doing PCC Data
  • ORDERABLE ITEM:
  • FINDING ITEM:  Not doing PCC Data
elements no pcc
Elements – No PCC
  • DIALOG/PROGRESS NOTE TEXT:
    • Is patient taking medications as directed?
  • ALTERNATE PROGRESS NOTE TEXT:
    • Patient’s medication compliance
  • EXCLUDE FROM PROGRESS NOTE:
  • SUPPRESS CHECKBOX:
  • Select ADDITIONAL FINDINGS:
  • RESULT GROUP/ELEMENT:
  • Select SEQUENCE:
elements add prompts
Elements – Add Prompts
  • Select SEQUENCE: 1

ADDITIONAL PROMPT/FORCED VALUE: SIDE EFFECTS prompt LOCAL ...OK? Yes// (Yes)

  • OVERRIDE PROMPT CAPTION:
  • START NEW LINE: 1 YES
  • EXCLUDE FROM PN TEXT:
  • REQUIRED:
  • Select SEQUENCE: 10

ADDITIONAL PROMPT/FORCES VALUE: PXRM COMMENTS

OK? Yes//  Need this one for local prompts to appear

element education topic
Element – Education Topic
  • Select DIALOG to add: ED HTN MEDICATIONS
  • Are you adding ‘ED HTN MEDICATIONS\' as a new REMINDER DIALOG (the 83TH)? No// YNAME: ED HTN MEDICATIONS//
  • DISABLE:
  • CLASS: L
  • SPONSOR:
  • REVIEW DATE:
  • RESOLUTION TYPE: DONE AT ENCOUNTER
element education topic1
Element – Education Topic
  • ORDERABLE ITEM:
  • FINDING ITEM: ED.HTN-MHTN-MEDICATIONS HTN-MEDICATIONS HTN-M

...OK? Yes//

  • DIALOG/PROGRESS NOTE TEXT:
  • The patient is able to verbally summarize their medication regimen
  • and the importance of compliance with therapy.
  • Edit? NO//
  • ALTERNATE PROGRESS NOTE TEXT:
  • No existing text
  • Edit? NO//
  • EXCLUDE FROM PROGRESS NOTE:
  • SUPPRESS CHECKBOX:
element education topic2
Element – Education Topic
  • Select ADDITIONAL FINDINGS:
  • RESULT GROUP/ELEMENT:
  • Select SEQUENCE: 1

ADDITIONAL PROMPT/FORCED VALUE: PXRM LEVEL

1 PXRM LEVEL OF SEVERITY prompt NATIONAL

2 PXRM LEVEL OF UNDERSTANDING prompt NATIONAL

CHOOSE 1-2: 2 PXRM LEVEL OF UNDERSTANDING prompt NATIONAL

OVERRIDE PROMPT CAPTION:

START NEW LINE: 1 YES

EXCLUDE FROM PN TEXT:

REQUIRED: 1 YES

  • Select SEQUENCE: 10

ADDITIONAL PROMPT/FORCED VALUE: PXRM COMMENT//

OVERRIDE PROMPT CAPTION: PXRM COMMENT//

START NEW LINE: Y YES

EXCLUDE FROM PN TEXT:

REQUIRED:

element order
Element - Order
  • Select DIALOG to add: OI HYPERTENSIVE MEDS

Are you adding \'OI HYPERTENSIVE MEDS\' as

a new REMINDER DIALOG (the 84TH)? No//

  • DISABLE:
  • CLASS: LOCAL//
  • SPONSOR:
  • REVIEW DATE:
  • RESOLUTION TYPE: ORDERED

...OK? Yes// Y (Yes)

  • ORDERABLE ITEM:
  • FINDING ITEM: Q.PSOZM HYPER PSOZM HYPERTENSION MEDS
  • ...OK? Yes//
element order1
Element - Order
  • DIALOG/PROGRESS NOTE TEXT:
  • Check to order or change medications

Edit? NO//

  • ALTERNATE PROGRESS NOTE TEXT:
  • Medication change ordered

Edit? NO//

  • EXCLUDE FROM PROGRESS NOTE:
  • SUPPRESS CHECKBOX:
  • Select ADDITIONAL FINDINGS:
  • RESULT GROUP/ELEMENT:
  • Select SEQUENCE:

Input your edit comments.

Edit? NO//

group makes it prettier
Group – Makes it prettier
  • A group allows you to put several elements together. Groups can be hidden until clicked so they act like templates
  • Users may select 1 or more items in the group
group
Group
  • Select Item: Quit// AD Add
  • Select DIALOG to add: GRP HTN LIFESTYLE CHANGES
  • Are you adding \'GRP HTN LIFESTYLE CHANGES\' as
  • a new REMINDER DIALOG (the 97TH)? No// Y
  • NAME: GRP HTN LIFESTYLE CHANGES Replace
  • DISABLE:
  • CLASS: L
groups
Groups
  • SPONSOR:
  • REVIEW DATE:
  • RESOLUTION TYPE:  Would apply
  • ORDERABLE ITEM:  to entire group
  • FINDING ITEM: 
  • GROUP CAPTION:
  • PUT A BOX AROUND THE GROUP: y
group1
Group
  • SHARE COMMON PROMPTS: 0
      • 1 yes
      • 0 no
  • MULTIPLE SELECTION: 2
      • 0 NO SELECTION REQUIRED
      • 1 ONE SELECTION ONLY
      • 2 ONE OR MORE SELECTIONS
      • 3 NONE OR ONE SELECTION
  • HIDE/SHOW GROUP: H
groups1
Groups
  • GROUP HEADER DIALOG TEXT:

Check to document lifestyle changes discussed with patient

Edit? NO//

  • GROUP HEADER ALTERNATE P/N TEXT:

The following lifestyle changes were discussed with the patient/family:

Edit? NO//

  • EXCLUDE FROM PROGRESS NOTE:
  • SUPPRESS CHECKBOX:  If you want it mandatory

or for headers

  • NUMBER OF INDENTS: 2
groups2
Groups
  • INDENT PROGRESS NOTE TEXT:y
  • Select ADDITIONAL FINDINGS:
  • Select SEQUENCE: 1
  • DIALOG ELEMENT: ED HTN-WEIGHT CONTROL dialog element LOCAL

...OK? Yes//

EXCLUDE FROM PN TEXT:

  • Select SEQUENCE: 2

……Continue to add elements to the group

dialog the upper level
Dialog – The upper level
  • The dialog is now ready to be created
  • Dialog can be made up of elements and/or groups
dialog
Dialog
  • Select Item: Quit// AD Add Reminder Dialog
  • GENERATE DIALOG AUTOMATICALLY: Y// NO
  • Select DIALOG to add: HTN INTERVENTION

Are you adding \'HTN INTERVENTION\' as a new REMINDER DIALOG (the 98TH)? No// y

  • NAME: HTN INTERVENTION
  • DISABLE:
  • CLASS: l LOCAL
  • SPONSOR:
dialog1
Dialog
  • REVIEW DATE:
  • SOURCE REMINDER: HTN INTERVENTION LOCAL
  • Select SEQUENCE:
    • Can enter the sequence number for what you want on the dialog OR
dialog2
Dialog
  • Select the dialog
  • Select Sequence: Quit// 5
  • ARE YOU ADDING 5 AS A NEW SEQUENCE NUMBER: N// y YES
  • Select new DIALOG ELEMENT: GRP HTN LIFE
dialog3
Dialog
  • Puts it in
  • Often leave spaces between items for later editions
  • Easiest way to edit a dialog
  • Can edit, delete, copy items
attaching to a reminder
Attaching to a Reminder
  • A dialog made this way does not need to be attached to a reminder
  • It can be a dialog template to be used in notes
  • If it has a source reminder, you must go back to the reminder and attach it.
  • Select CV to change view and go to R for reminders
attaching
Attaching
  • Choose LR to link reminder
  • LINKED REMINDER DIALOG: HTN INTERVENTION reminder dialog LOCAL

...OK? Yes//

attaching1
Attaching
  • How do you view this reminder?
  • Add it to the list for the EHR and then test
  • All changes must be made in RPMS
  • No editing in the GUI
test the dialog
Test the Dialog
  • Add this reminder to list
  • Start a note
  • View the reminder
test the dialog1
Test the dialog
  • Make changes until it looks the way you desire
  • Then make it available for all needed clinicians
test the dialog2
Test the dialog
  • If you added any orders, are they working correctly?
making a dialog tiu template
Making a Dialog TIU Template
  • A dialog can be used as a note template
  • Education dialogs are good examples since you don’t always know when you are going to do the education
  • They are still made in RPMS but not attached to a reminder
  • When finished, they must be available to TIU
attach to parameter
Attach to Parameter
  • TIU TEMPLATE REMINDER DIALOGS may be set for the following:

1 User USR [choose from NEW PERSON]

3 Service SRV [choose from SERVICE/SECTION]

4 Division DIV [DEMO HOSPITAL]

5 System SYS [DEMO.CIAINFORMATICS.COM]

tiu template reminder dialog
TIU TEMPLATE REMINDER DIALOG
  • Enter selection: 5 System DEMO.CIAINFORMATICS.COM
  • - Setting TIU TEMPLATE REMINDER DIALOGS for System: DEMO.CIAINFORMATICS.COM -
  • Select Display Sequence: 1
  • Display Sequence: 1// 1
  • Clinical Reminder Dialog: TEST// TEST reminder dialog LOCAL

...OK? Yes// (Yes)

  • Select Display Sequence: 2
  • Are you adding 2 as a new Display Sequence? Yes// YES
  • Display Sequence: 2// 2
  • Clinical Reminder Dialog: HTN INTERVENTION reminder dialog LOCAL

...OK? Yes// (Yes)

tiu reminder dialog
TIU Reminder Dialog

Make a new template

New Type – Reminder Dialog

reminder templates
Reminder Templates

Attach it to the reminder dialog

reminder templates1
Reminder Templates

Its now available in the template drawer

reminder templates2
Reminder Templates
  • These templates CANNOT be part of any other TIU template
  • If you add it as a “sub template”, TIU will skip over it
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