ACHN EMR: November 2010

Tuesday, November 30, 2010

Auto Text (Dr. Barker)

Auto Text is much more flexible and useful than Macros. First of all you can use an Auto Text in any Note type. Secondly you can use an Auto Text in any place in any Note. In this tip you will learn how to create and insert Auto Text. In the next one you will learn how to turn one of our current templates into an Auto Text.

So lets say that I see a number of patients from nursing homes in my clinic and I want to be able to use the phrase “nursing home staff” in places like the “Accompanied by” sentence or the “History limitation sentence”. If I made a Macro it would be tied to that sentence – if I make an AutoText I can use it anywhere.

So I start by opening the OTHER text box in “Accompanied by”, but this time after typing “nursing home staff member” I right click the text box and one of the choices is “Save as AutoText” I click that choice.

This box will open and I need to give it a name – I’ll call it qqNHstaff for reasons that will become apparent. You can give it a description as well if you want. Click the Create button and then the Close button.

One important thing about naming these – you want to use at least a pair of characters that never appear together at the beginning of a word or sentence. Small case zz or qq are good choices, but you can use others like symbol characters. The reason is that if you create an AutoText with a usable abbreviation, every time you start to type that word it will ask if you want to insert the AutoText that starts with those symbols. Say for example you created an AutoText and named it “Thebomb” every time you type “Th” the insert AutoText window will pop-up; which will get very old, very quick. So – at least as a starting place use AutoText names that start with “zz” or “qq”.

Having created this new AutoText (notice after hitting create it appeared in my list of AutoTexts). I can reuse this anywhere I want – like in the “History limitation section”. If I click the OTHER in that section – the dialog box opens to freetext but now I type “qqN” and it offers my new AutoText in the Pop-up within the box. I click on it and it inserts the text.

Mouse click the name of the AutoText (you can also hit the down arrow key until you highlight the one you want) and it will be inserted and click OK,

This may not seem like a big advantage for a short piece of text but one of the differences is that there is no size limit on AutoTexts. And more importantly you don’t have to use an OTHER box to insert one.

The blank spaces that appear at the end of each paragraph can be clicked on and you can just type there if you want. The text that you type will appear under the paragraph name in the final note rather than any single sentence. So for example I could go to “Interval histories” and click on the white space after the paragraph and just type what ever I want – in this case I collapsed the paragraph by clicking <hide structure> just to get it out of my way.

Even better is the fact that I can insert AutoTexts in these white spaces without bothering to use the OTHER boxes in the sentences. In this case I am inserting an AutoText that I use to document counseling a patient about adherence. This AutoText’s name starts with “zz”. Note that you never have type the whole name (or even remember the whole name of the AutoText) just enough to cause the window to Pop-up.

I highlight my choice and click on it and it inserts the text of the whole AutoText. Keep in mind that the names are case sensitive so zzadherence and zzAdherence can be different and appear at different places in your AutoText list.

Last thing for this tip – text typed in the white spaces after a paragraph can be used to create an Autotext. Left click your mouse either before or after the text you want to use to create an AutoText and holding down the left button drag it across all the text you want to include – it will become highlighted in black. Then right click the highlighted phrase and select “Save As Auto Text”. Go through the same steps – name it – click create – then click close and you will have another AutoText.

Try not to get carried away with making too many of these or you will end up having to scroll through long lists of them to find the one you want.

Making Macros (Dr. Barker)

In basic computer speak a Macro is a series of steps that are done together, and the series is identified by a title or a short-cut command. In Cerner PowerNotes you can create blocks of text that you use frequently and store that as a Macro.

So lets say that I see a lot of new patients referred from the STD Clinic and I want to be able to document that referral source. I go to the “Referral Source Section” and click on “Other”

When the text box opens up I type my text… “CORE STD Clinic” and click OK

The text is inserted in this note, but what if I know I need to be able to use it in future notes on other patients.

Place your pointer over the text you want to be able to reuse- and click the right mouse button. A pop-up menu appears and you can choose “Save Macro As”

Left clicking “Save Macro As” should get you here.

You should rename this Macro, names that are highlighted in Dark Blue the way OTHER is here are set to be replaced when you type – I am going to call mine “CORE STD” – so I just type that as a name. Then click the “Create New” button at the lower left.

You should now have a new Macro denoted by the blue M. You will notice that the “OTHER” free text section reappeared to the right after I used it to type in the CORE STD Clinic text – this is so that I could make additional free text entries if I needed to – because my Macro is associated with the OTHER item the Macro M appears there as well.

What if I have alternative referral sources I want to be able to document? There is no limit to the number of Macros that can co-exist in one item. So I can make as many additional one as I need. Here I am making one that says “CCH Emergency Room” – the M you see is the CORE STD Clinic Macro.

If I create multiple Macros in the same item only one M appears but when I click on the M I get a list of the possible Macro choices – just click on the one you want.

Multiple choice Macros seem to get alphabetized by title – so if you have a particular favorite you might want to call “aaWhatever” so it is at the top of the list. Macros can be much longer than these simple ones – they can be whole paragraphs.

The downside of Macros – they are very specific. They are tied to that element, in that paragraph, of that Note Type. So a Note type could have hundreds of Macros associated with specific elements but they generally will not show up in any other Note. They are useful because they can free us from having to do repetitive documentation.

When is it worth creating a Macro – when there is something you need to document repeatedly at a specific point and there is one, or just a handful of choices. Unusual occurrences that will not happen again aren’t worth it.

For something more widely useful we need to talk about AutoText – next time.

Sunday, November 28, 2010

RX Writer (Dr. Stabile)

Power Chart/Rx-wrtier tip:

Everyone may have figured this out already, but in Power Chart you can print a "patient friendly" version of the medication list just like in PCO. You selected "task", then "reports" and check "medication list". That prints up the list in an understandable way for patients.