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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



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



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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