New automation for dr office

Hi Gang, need your help here for a family member. She is a Dr. What we are looking for is to have some kind of templates where for example she can fill at the top some variables and that will calculate like date of birth and then she can go thru the patient history and some other information and just change what is needed and remove what is not. She used to work at another hospital where for example she had @patient_name@ @age@ and that will automatically generate that based on todays date that was automatically inserted when opening the file and added the date of birth. I know that @MacSparky and @RosemaryOrchard have mentioned that he has some automation like this but can’t remember the software that can be used. One thing is that it should be easy to be exported to a .txt or something that can be send to some old system as text.

Any help or guidance will be appreciated. The fun thing is that I will need to learn what you send me to then teach it…

Thank you as always, and take care.
Luis

Based on what you have said, I suspect she previously used an EHR called EPIC (as EPIC uses variables brackets by the @ sign to pull data from the patient’s information in the database). To recreate the kinds of templates that you can created in a dedicated system like this is not all that easy.

I would think about creating text snippets that contain fill-ins for various fields that need completion. Although I personally use both Keyboard Maestro and Alfred for creating snippets, because my needs are not all that complex in this area, this would be the kind of application where I would lean more towards TextExpander.

She could create, as an example, a snippet for the demographics information which included the necessary fill-in fields for date of birth, name, gender, etc, and could embed the appropriate calculations for age from the date of birth, using the ability to incorporate scripting in virtually any language into a snippet.

Other snippets could fill in fields for the other needed parts of a medical note (eg review of systems, family history, physical examination). She can start by just having these snippets insert a text block that she then edits “by hand” to customize for the specific patient, but as she assesses her workflow and her needs, she can expand (no pun intended) those snippets to include fill ins fields, lists, sub snippets, and the like to create a more comprehensive system.

As an example, years ago before the advent of EHRs, when I used to create my office notes in Word, I had created a script (in TE which I used at the time) which used a pop up dialog box to get the patients first and last name, date of birth, and gender, and the name of the referring physician. The script then pulled the physician’s full name/title and mailing address from my Contacts (née AddressBook) database, opened a new Word document, figured out where on disk the file should be saved, saved the document with the proper name based on the patient’s name and date of birth, and inserted a template letter. Saved a lot of tedious and repetitious work and made sure the letters were formatted correctly and properly saved.

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Whatever you end up doing, given that this is related to patient information, make sure that the tools and methods that you choose are compliant with whatever regulations apply, especially tools that have a cloud processing/sharing component.

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TextExpander could handle this very well.

It has some advanced “snippet” features - and they can be supplemented with Javascript if there is anything additional you need it to do that is not built in.

I am looking for something similar. I also use Epic EHR, but am not always in the same hospital system. Also would like to have access to snippets on both Mac and windows. The kicker is work computers you can’t install software. The best I have come up with so far is phrase express which is a portable app you can run on usb on windows pc’s at work. There are Mac and PC dedicated versions as well, but they are a bit clunkier than text expander. You also have to manually update to the usb version of the program rather than having syncing.

At this point I don’t see a viable 1 stop solution between Mac/pc. phrase express on a usb drive to take to multiple computers (without having to install) is the best I have come up with, but hoping there is a better answer out there.

(Preface - I am a dinosaur - a solo practice physician who intends to be the very last solo practitioner in the USA.)

The answer is simple - Either join a small group where doctors are partners (not employees), or go into solo practice. Then you can set up whatever systems you want.

I am private as are many, but work both in and out patient. I want one app to keep everything together for whenever I practice.

So your remarks were not helpful, judgemental, and did not provide a solution. Please keep your personal beliefs about how you practice to yourself. A bit disheartening for a colleague to make implications about someone else based on your own beliefs. Not the right forum for this. If you can’t answer or offer a tech solution take those comments elsewhere.

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No offense meant - it was a serioius response. Not all tech problems have tech solutions.

My point - perhaps better phrased than my initial tongue in cheek response - is that management can often make IT decisions in the name of “security” which might in reality have more downside than upside.

I’d be more than interested to learn how various businesses create IT restrictions - and how others have responded to that, either in technical terms or in corporate terms.

This is absolutely true. It makes it unnecessarily locked down. And going between multiple medical record systems, pc, Mac etc a usb device seems great to take all your text phrases to be efficient everywhere rather than re build them on each computer.

If only text expander had a usb app that ran portably would be perfect….

I’m surprised you’re allowed to do this.

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@jmanko16

Unfortunately, I do not know if any reasonable solution for keeping snippets (or EPIC smart text and smart phrases in sync between multiple EPIC installations. This is true even if the same version of EPIC is installed in each location.

I would be surprised to find a hospital or medical practice large enough to be using EPIC that allows installation of software like TextExpander, for instance; hospital IT tends to be highly locked down, and for reasonable reasons, I suppose.

Sadly, you also cannot export your customizations from EPIC into a format that can be readily imported into another EPIC installation either, so once you have done all the work of creating sophisticated customizations in one facility, you pretty much have to recreate the work at the second location.

One option that might work is if your facilities are using Dragon for speech recognition. You can export your Dragon dictionary and import it to another Dragon installation, which is what I have done. As a result, while I have a fairly large library of EPIC phrases, I have a substantial portion of my “boilerplate” text snippets in Dragon instead, which I can then save to a USB drive and install at another site.

@jec0047

I would expect most hospitals and other medical facilities to “officially” prohibit the connection of personal external drives to their computers, but in practice I have little doubt it is done all the time. There are many reasons why this gets done, some of which could but are not addressed by the official IT infrastructure.

We use dragon at one facility and M-modal at another. My primary site I have text expander on office and documentation PC for clinic, but not the rooms. It’s the coverage at other sites with another epic I am trying to duplicate.

The text expander for personal use and then on primary 2 PCs, with manual export to portable phrase expander on usb for weekends at other facility isn’t horrible. Definitely not able to incorporate forms well but for all the snippet phrases it still saves time.

In my former line of work this sort of thing was grounds for being fired. I would think, given the recent spate of healthcare breakins and ransomware, hospitals would take similar stances.

They seem pretty clear can’t install software unless vetted. Both sites recommend using usb flash drives and bringing with you to store data as needed rather than on the pc. But I can see the point.

Can you use a cloud-based document generation system and then copy/paste to the EHR?

If it was cloud based/web based sure. I’m not sure this would be as efficient as just taking the time to copy my primary phrases to the emr of choice, but what would you recommend?

Anyone from the Irish health service could probably shed some light on the reasons behind why these sorts of restrictions are in place :slight_smile:

Can’t say I would “recommend” it at this time as I am just doing research for a project I am considering.

But Knackly seems interesting

It’s not cheap but can automate some sophisticated workflows

There are much cheaper alternatives available for simpler levels of automation so it depends what your goals are.

Formstack and Jotform are alternatives. Many many others.

FWIW I worked for a Fortune 100 company in the 90’s and a small-medium size company until 2018. At both jobs I set the I.T. policy. In general I did not allow anyone to install software except I.T. staff. I had several reasons but the three main reasons were:

  1. Security - I needed to insure that all software was safe to install,
  2. To prevent software conflicts.
  3. To simplify support.

In the days when anyone could install software it was a constant game of ‘whack a mole’. Users would install something or make changes, etc. then call me to fix their problem. This continued until Windows NT which allowed admins to set policies on the network and our support calls immediately dropped to a small fraction of what they had been.

At both companies we had a standard software set up for both our PCs and Macs, and we added to that any additional software that was needed to do the job.

Sometimes I would make the decision, other times I would work with department managers to make a selection. And if an employee could convince his manager, and the budget allowed, we occasionally took “special orders” for software.

The only advice I can give is to talk to your I.T. department and see if it’s possible to get the software you want. At worst you may learn the reason it is denied, and at best they may agree to install it.

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Well they do allow it with permission (as already stated), but can’t be on every hospital in the whole place. And the usb app is portable….aka does not actually install anything which is the point.

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