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Patient Mobile Rounds

Author:Daniel Levy, MD [Send Author Email]

June 03, 2008
September 06, 2009
Description:My Cardiology Group has been using the Patient Mobile Rounds Applet successfully for the past 4 years and it has revolutionized and transformed our practice! The power of it comes from the way we utilize a three check box system in conjunction with "Views" to isolate patients into categories. By using an "empty shell" identical database for group emailing, we keep "wirelessly synchronized". It also generates our daily bills. We have carefully chosen which fields export in each view. For example, we generate a daily bill by exporting relevant fields from the "Seen Patients" view. By exploiting the fact that smaller HanDbase databases can be sent as email attachments, we keep all of our databases perfectly synchronized on our devices wirelessly, via a group email system. Our Cardiology group has been using following HanDbase system for the past 3 years. Our database contains about 8,000 patients! Because it provides "point of care" information, it has streamlined patient care for us. By sharing critical patient information digitally, we all have up to date patient information right on our cell phones!!! The system is simple to use and teach to others. I have taught it to physicians with no prior mobile computing or database experience. To keep it as simple as possible we have decided not to use forms, to avoid an extra layer of complexity. For Physicians using this system, data entry is almost self explanatory. HIPPA compliance can be maintained with the built in encryption feature. ACTIVE VS. INACTIVE PATIENTS: An “Active Patient” is a patient that you (or your group) are actively following. An “Inactive Patient” is one that you (or your group) is not longer following, however, you want to retain the information for when you need to follow the patient again. When you open a new record, the first field is a pop up field to delineate "Active Vs Inactive" patients (Active: Yes or No). SEEN CHECK BOX: After you seen a patient and deliver care, check the “SEEN” check box. Scroll down to the “Level of Visit” which has a pull down menu of frequently used CPT Codes (which you can edit if needed). Add information to the “History field” (there are 2 of them, each has a 2000 character capacity). If you are in a group practice, new information you added to the history field of an established patient can be copied and pasted to an email, to update your colleagues, so that they can copy/paste the new information to that patients History field in their database. NEW PATIENTS: Tap the “New Record” Icon to open a new record. Enter the patient’s name, MR# (Medical Record Number), SSN (Social Security Number) if needed, and DOB (Date of Birth) which is a Calendar, which then gives the patient’s age automatically. In the History fields, I recommend adding dates to major events for future reference. There is an extensive pull down menu for the first history field of common medical terms which could, of course, be edited to suit the users needs. Check the Seen box and the New box. Fill in the “Referring MD” and add your frequent refers to the pull down menu. The “Diagnosis” field has a pull down menu to add frequently used Diagnosis with ICD-9 codes. The “level of visit” pull down menu can be edited to suit you practice needs. The “AUTOMATICALLY ENTERED DATES” are set to when the field was first added and when the field was last modified. The “Seen 1st by” is helpful in a group practice. SIGN OFF BOX: If you a signing off or discharging a patient, check the “Sign Off” Box. Do not change the “Active” Field until after you do your billing (see below). You can create a list of the “Sign Offs” by going to the “Sign Off” view. Tap “Actions -> Export records to text. Choose a file name (such as “Today’s Outs”) and select a folder. You now have a text document of your “sign off” list which you can email to colleagues. DAILY BILL: The daily bill is generated by changing view to the “Seen Patients” view. This view only shows you the patients with the “SEEN” check box checked. Tap “Actions -> Export records to text. Choose a file name (such as “Dr. Smith’s daily bill) and select a folder. You now have a text document of your daily bill which you can email to your billing system. SENDING NEW PATENTS TO A COLLEAGUE: If you are in a group practice, you can email the new patients in database form to your colleagues so that they can "absorb" these new patients into their patient list. Go to the ”Today's New Patients” View. Tap “Action -> Copy records to…” then tap the “For Emailing” Database. Make sure the For Emailing Database was initially empty (Action ->Delete Records). The For Emailing Database can now be emailed to your colleagues as an email attachment. Encryption can be used for HIPPA compliance. When the email is received, the records from the emailed database are then moved to the main database on the receiver's device (Action ->Move records to...). This system can replace telephone signouts. MOVING ACTIVE PATIENTS TO INACTIVE: After you created your daily bill, change to “Today’s Outs” view. Open the individual records and tap the Active field (the 1st field) to change the "Yes" to "No". FINDING INACTIVE PATIENTS AND MOVING THEM TO ACTIVE: Change to the “INACTIVE” view. Tap Action ->Find. You can choose to search by patient's Name, MR #, SSN. Open the record and tap the Active field (the 1st field) to change the "No" to "Yes". Note that all the RED buttons of the Form contain useful pull-down menus.
Has Data:No
Has Forms:Yes
Filters:For simplicity, the Patient Mobile Rounds "Views" are carefully set up to implement various filters automatically. The user need not add their own filters, provided that the user properly used the check box system. For example, the "Seen Patients" View automatically filters the patients that were seen that session, to generate a daily text bill (by exporting to text in that view). The "New Patient" View isolates records to copy to the "For Emailing" database, to share new patients with your colleagues (and therefore keep your databases wirelessly synchronized). From the "Sign Off" View, a text file can be generated by exporting to text, which provides a list of patients to move from "Active" to "Inactive". This text file can be emailed to colleagues to keep your colleagues databases wirelessly synchronized. The "Inactive" patients are saved and upon readmission to the hospital, by changing the "Active" Fields pull-down menu from "No" to "Yes", the patient's record is now moved and available in the active lists.
Sorting:For simplicity, the "Views" are carefully set up to sort the records for the user automatically. The user need not do their own sorting. For example, The "By Ward" View sorts the active patients by Hospital Ward. The "Alphabetical Active" View sorts the Active patients in alphabetical order. The "Inactive" View is also sorted by alphabetical order. Tap Action -> Find... to find an Inactive patient. When that patient is readmitted to the Hospital, by changing the "Active" Fields pull-down menu from "No" to "Yes", you change the status of that patient from "Inactive" to "Active".
Comments:When we first used HanDbase, we had NO PRIOR EXPERIENCE with database construction. Your product made it easy to create a system that literally revolutionized our medical practice We believe that our Patient Mobile Rounds Applet is the perfect example of people using HanDbase with NO PRIOR DATABASE EXPERIENCE, and creating an incredible database system which enhanced our medical practice to the benefit of our patients and our colleagues. Having a "For Emailing" blank database to email new patient records, and a check boxes that work in conjunction with various "Views", our databases are be kept "wirelessly synchronized". Information can be added to the database durning outpatient visits as well as hospitalizations. We strongly believe a mobile, "point of care" system such as this would be beneficial to all physicians who strive for excellence in delivering care. Physicians will immediately see the utility of having a handheld patient information management tool that streamlines patient care and generates a daily bill. This system replaces the "telephone signouts" and therefore, precious time is saved. Note: Feel free to Email me with feedback or questions. Forms are still somewhat buggy with HanDBase 4.1 on Windows Mobile. I have developed a form for the applet but have not included it in the ZIP file. I believe this will be resolved in the next HanDBase WM update. Once it works without bugs, I will add the form into the below ZIP file. The system works well without the form, but the form really dresses things up nicely. In addition to being a Cardiologist, I am a mobile tech enthusiasts and I would love to get feedback from other folks who are "going mobile" with there medical practices.
Version:HanDBase v.4.x Enhanced or greater
File:rocket_rounds.pdb          Downloads: This Month 54 / Total* 2059
Note:MAC Users will need to enter the filename rocket_rounds.pdb when saving this file.
* since October 1, 2000.

Other Titles from Daniel Levy, MD

12/04/2009 Patient Database [Medical]
A Patient Database for HandBase that can be used as a mobile point of care database. It can also be used for group sign-out and daily billing. See detailed explaination in my older Applet named: PATIENT MOBILE ROUNDS