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Unsolicited but Greatly Appreciated Testimonial Mike Anderson, MD, FAAP
EncounterPRO Pediatric EMR Workflow System



Pediatric EMR Chart in 37 Seconds
Pediatric EMR

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SOME OF OUR FAVORITE BUTTONS


"WHY DO YOUR SCREENS
LOOK SO DIFFERENT?"


We get this question all the time. Our screens look unusual, because EncounterPRO is based on a completely different technology from that of traditional EMRs. It's based on a workflow management system (what is currently called "clinical groupware"). Compared to other non-workflow management system EMRs, EncounterPRO has larger and fewer buttons on each screen. Fitts's and Hick's laws state that a large target button among a few other non-target buttons are easier to hit quickly and accurately than a small target button amongst many competing target buttons. Data and order entry in EncounterPRO are fast because on each screen there are only a small number of large easy to hit targets.

So, you may ask, if each screen only has a few options, how can I do all the things I need to do during a patient encounter? By anticipating the sequence of screens, each with the relevant options appropriate to that task step, and presenting that sequence of screens to the user in quick succession. Each screen presents itself as part of the office workflow—bringing the right information, options, and tools to the right caregiver at the right time. The result is a decrease in the time it takes the physician to chart the vast majority of encounters, compared to competitors' systems or to paper charts.

 

EncounterPRO VIDEOS AND SCREENSHOTS

Videos:
 
1
Pediatrician Charts Routine Well Visit in 37 Seconds
The following two videos address two realistic pediatric scenarios included in this actual request for video demonstration of EncounterPRO:
1
Short Well Visit: Pediatrician Perspective (Version 5)
1
Short Sick Visit: Pediatrician Perspective (Version 5)
Older videos (Illustrating more screens, explaining our unique Office View and Workplan Definition Editor, showing that we've been building and demoing EMR workflow systems for years!):
1
Longer Sick Visit: Nurse and Pediatrician (Version 4)
1
Family Medicine: Nurse and Physician (Version 4)
1
Ob/Gyn: Nurse, (Version 4)
1
Ob/Gyn: Physician
(Version 4)
 
(Videos require Adobe Flash Player.)

 

Note that the order of the following screens is determined by the Standard Child Well Visit New Patient workplan. You can have different workplans for different visit types, different routine activities in your office, and even for different physicians who prefer different workflows.

   
 

OFFICE VIEW

The Office screen is a tool that gives the physicians and staff the information and choices they need to manage their patients from check-in to check-out. Among many other features, the Office Screen shows the name of the patient in each office location, the service that the patient requires (e.g., examination, taking of vital signs, specified tests and immunizations), and how long the patient has been waiting for each service (shown by the number of minutes in parenthesis). The screen also shows—through color coding—the provider of the service. In addition, an asterisk shows that a service is currently being performed. Each status bar is hot; touching it brings up the right screen to accomplish the task. EncounterPRO's Office View (called a "radar view" by usability engineers, for obvious reasons) is the most visible manifestation of what makes EncounterPRO different from traditional "singleware" EMRs. It's clinical groupware--and they're not.

 

VITALS

When the nurse or technician enters his or her code in the exam room with the patient, the vitals screen automatically opens (because this is what the customizable workplan tells the EncounterPRO workflow engine to do). Patient demographic information previously entered by the front office flows to the screen and is displayed at the top. This screen is configurable to the preferences of the practice, and anything entered with numerical values may be graphed.

 

CHIEF COMPLAINT

The Chief Complaint screen allows you to document the patient's reason for today's visit. You can enter complaints, the duration and onset of the symptoms, as well as noting any absent symptoms. If a symptom is not on the list, type it and then, if you wish, click "Add to List". Notice there are just a few (relative to other EMRs) big buttons. This is out of respect for Fitts and Hicks Laws in order to maximize quick, easy, and accurate data entry.

 

 

 

CURRENT MEDICATIONS

Medications noted in previous visits and those ordered by the provider appear automatically on the Current Medication screen. Add new medications as needed or close medications which have been discontinued to keep the list up to date. Some patients will not know the drug package, strength or dosage. When that occurs, you can still add the drug to the list, even if all you know is the name of the drug. If you later find out more information, you can remove the "placeholder" entry and add the medication with all the information.

 

ALLERGIES

This screen displays any allergies reported by the patient (or parent/guardian). Allergies can be drug, food, environmental, etc. The severity and reaction can be documented for each allergy. For established patients, the clinical staff should confirm the existing allergies or lack thereof at each visit. The 1-Touch buttons at the bottom of the screen allow staff to quickly document that the patient was asked and reported either No New Allergies or No Known Allergies (NKA). When an allergy to a medication is documented on this screen, EncounterPRO displays a red 'A' on all Treatment Lists for any treatments that are contraindicated due to the allergy.

 

ENCOUNTER SCREEN

The Encounter Screen is where the physician controls entry of patient data at the point-of-care. This screen is organized along the SOAP model. Below the demographic information and digital photograph, vitals are displayed along with other pertinent patient information. Tabs on the bottom bring up screens showing the open and closed assessments; drug histories; the child's development chart; and the documents that have been scanned into the patient's record. The area in the center of the screen shows a summary of the current encounter. Touching any line brings up details. The button on the left allow a review of past encounters, showing all associated observations, diagnoses, and treatments.

 

PHYSICAL EXAM

Using the Physical Exam screen, the physician drills down to the abnormals and relevant normals in a few seconds. For a typical illness or well visit, the touch of a single button (customized by the physician to document all of the characteristics of that condition) records all the physical observations. This screen can be customized to reflect the preferences of the physician.

 

ASSESSMENTS

If the patient's ailment is common, the physician touches one of buttons describing the most common assessments he uses in his practice. If the ailment is not among the pick list, he or she can search alphabetically or categorically for every ailment that has an associated current ICD code. At this point the ICD code can also be permanently added to the picklist for future use.

 

TREATMENTS

This screen is pre-configured by each physician to present the common treatments for each assessment. If the treatment that the physician prefers is not here, he or she may search the database by clicking the "New Treatment" button on the right, or typing in an appropriate treatment on the keyboard (which can be added on to the picklist on the fly for future use). With the Composite Treatment bar, the physician can order a set of treatments with a single touch.

 

PRESCRIPTIONS

If the physician selects a drug as a treatment, EncounterPRO automatically brings up the prescription screen. EncounterPRO calculates the dosage based upon the patient's current weight (entered from the vitals screen) and shows the physician's default settings for that particular drug. The physician can change the data shown on each gray bar by touching the bar and then touching a selection from the list that appears. EncounterPRO then recalculates the data based upon the new selection. Every prescription is reviewed again when the physician electronically signs for the encounter and the prescription. (If you have SureScripts e-prescribing enabled, there is one extra click.)

 

BILLING APPROVAL

At the end of each encounter, the Billing Screen permits review of the prescriptions and the billing data generated by the treatments and procedures selected during the encounter. Touching the billing block brings up a screen that permits billing adjustments and the addition of billing notes, either from an editable menu or by keyboard. This screen also allows a provider (e.g., a nurse practitioner) to request a recheck by another provider.

 

Pediatric EMR Demo

 

 

 

WORKPLAN (PROCESS DEFINITION) EDITOR

Consider the order of the previous screens: Office View, Vitals, Chief Complaint, Medications, Allergies, and so on. Suppose you wanted to add your favorite Past Family and Social History to the workflow. This can easily be done by going to the Workplan Definition screen. (Workplans are the same as what are referred to as workflow "process definitions" in the workflow management/business process management systems industry.) The first step "Get Patient" occurred when a nurse took the patient to an exam room and clicked on that room in the Office View screen. The rest of these picklist items "programmed" the workflow engine to push the sequence of screens presented to the nurse. You'd click on "Add Step," rummage around amongst the hundreds of screens and screenless tasks in the EncounterPRO EHR Workflow Management System, and add it to the workflow, as seen has been done here. EncounterPRO's ability to execute workplans to push tasks to users is what makes EncounterPRO a workflow system. Workflow systems are clinical groupware. EncounterPRO combines to two most important kinds of clinical groupware: the kind that makes sure that groups of users execute routine tasks quickly and correctly, and the kind that helps groups of users "see" each other within a virtual care coordination space so they can depart from highly routinized behavior when this is needed.

 
Quote of the Day:  
Recent Blog Post: ACM, Clinical Groupware, and Routine vs. Non-Routine Workflow in Pediatric Practice
EncounterPRO EMR Customer in the Spotlight: Cooper Pediatrics (Winner of the HIMSS Davies Award)
 
HIE / Interfaces

 

EncounterPRO Pediatric EMR WORKFLOW SYSTEM SITEMAP

Home

THE HIGH-USABILITY ENCOUNTERPRO PEDIATRIC EMR WORKFLOW SYSTEM
WHAT KIND OF EMR WOULD A PEDIATRICIAN, JET PILOT, AND COMPUTER SCIENTIST DESIGN?
HOW TO CHART A PEDIATRIC ENCOUNTER IN 37 SECONDS (VIDEO)
INTEGRATED OR BEST-OF-BREED EMR/PMS APPROACHES
HIE / INTERFACES: LABS, REGISTRIES, DEVICES, PMSs
DIRECT INTERFACE TO SURESCRIPTS ELECTRONIC PRESCRIBING NETWORK
FAMILY MEDICINE, OB/GYN, AND OTHER SPECIALTIES
EncounterPRO PEDIATRIC EMR ROLLOUT & GO-LIVE SYSTEM ("LIVE IN FIVE!")
WHY TRADITIONAL EMRS ARE INADEQUATE AND A FUNDAMENTALLY NEW DESIGN IS REQUIRED
"WHY DO YOUR SCREENS LOOK SO DIFFERENT?"
USABLE WORKFLOW: NATURAL, CONSISTENT, RELEVANT, SUPPORTIVE, AND FLEXIBLE
MORE NATIONAL AWARDS THAN ANY OTHER PEDIATRIC EMR
OUR MANAGEMENT TEAM (And a Short Editorial)

Pediatric EMR

PEDIATRIC-SPECIFIC FEATURES OF THE ENCOUNTERPRO EMR WORKFLOW SYSTEM
TOP TEN REASONS PEDIATRICIANS CHOOSE ENCOUNTERPRO
PEDIATRIC-SPECIFIC FEATURES

Other Specialties

IDEAL FOR ANY HIGH-VOLUME, LOW-MARGIN AMBULATORY MEDICAL SPECIALTY
ENCOUNTERPRO FAMILY MEDICINE EMR WORKFLOW SYSTEM
ENCOUNTERPRO OBSTETRICS & GYNECOLOGY EMR WORKFLOW SYSTEM
ENCOUNTERPRO "YOUR SPECIALTY" EMR WORKFLOW SYSTEM

Usability

PEDIATRIC EMR USABILITY
TRADITIONAL EMRS VERSUS EMR WORKFLOW SYSTEMS
THE PRINCIPLE OF NATURAL WORKFLOW
THE PRINCIPLE OF CONSISTENT WORKFLOW
THE PRINCIPLE OF RELEVANT WORKFLOW
THE PRINCIPLE OF SUPPORTIVE WORKFLOW
THE PRINCIPLE OF FLEXIBLE WORKFLOW
THE IDEAL PEDIATRIC EMR (WORKFLOW SYSTEM)

Workflow

THIS IS YOUR EMR, THIS IS YOUR EMR ON WORKFLOW
EMR WORKFLOW SYSTEMS 101
CAT, DOG, TREE!
EMR WORKFLOW SYSTEM GLOSSARY

Chart in 37 Seconds

HOW TO CHART A ROUTINE ENCOUNTER IN 37 SECOND (VIDEO)
SO LET'S CHART A PATIENT

EMR / PMS

INTEGRATED OR BEST-OF-BREED PRACTICE MANAGEMENT SYSTEM
EncounterPRO PEDIATRIC EMR + ENCOUNTERPRO PM
EncounterPRO PM SCHEDULING
EncounterPRO PM BILLING
EncounterPRO PM REPORTING
EncounterPRO PEDIATRIC EMR + YOUR PRACTICE MANAGEMENT SYSTEM

Your Rollout

THE EncounterPRO ROLLOUT & GO-LIVE "SYSTEM"
AN INDUSTRIAL ENGINEERING APPROACH TO YOUR EMR ROLLOUT & GO LIVE EXPERIENCE
THE EncounterPRO PEDIATRIC EMR IS DESIGNED TO BE USABLE
THE EncounterPRO PEDIATRIC EMR IS DESIGNED TO BE LEARNABLE
ADDENDUM: EncounterPRO's INDUSTRIAL ENGINEERING FOUNDATIONS

14 National Awards

FOURTEEN NATIONAL AWARDS (PLUS BEST IN GEORGIA)
HIMSS DAVIES AWARDS (2003, 2004, 2005)
MEDICAL RECORDS INSTITUTES AWARDS (TEPR)
MICROSOFT INDUSTRY SOLUTION AWARDS
MICROSOFT HEALTH USERS GROUP AWARDS
HEALTH MANAGEMENT TECHNOLOGY PLUS BEST IN GEORGIA AWARD

Blog (Takes a moment to load.)

WHY WE BLOG ABOUT EHR WORKFLOW MANAGEMENT SYSTEMS
RECENT BLOG POSTS

E-Prescribing

WHY E-PRESCRIBING IS BETTER ON AN EMR WORKFLOW SYSTEM
WHO IS THE E-PRESCRIBING WORKFLOW ENGINE? YOU OR THE COMPUTER?
THREE CLICKS, LARGE BUTTONS...
...VERSUS NINE CLICKS, SMALL BUTTONS
WHAT KIND OF PRESCRIPTIONS CAN BE SENT ELECTRONICALLY?
WHO CAN USE E-PRESCRIBING?
HOW DOES E-PRESCRIBING WORK IN EncounterPRO?
WHERE DO THE PHARMACIES COME FROM?
HOW ARE ELECTRONIC REFILL REQUESTS HANDLED?

HIE / Interfaces

EncounterPRO HEALTH INFORMATION EXCHANGE (EPHIE)
WHAT IS EncounterPRO's CONNECT, COMMUNICATE, AND COORDINATE VISION?
ELECTRONIC LAB RESULT MANAGEMENT WORKFLOW
STATE IMMUNIZATION REGISTRY WORKFLOW
WHAT DO THE NEXT FIVE YEARS HOLD?: THE EHR NETWORK EFFECT
SuresScripts E-PRESCRIBING WORKFLOW
PRACTICE MANAGEMENT WORKFLOW
MEDICAL DEVICES

Screenshots

"WHY DO YOUR SCREENS LOOK SO DIFFERENT?"
EncounterPRO VIDEOS AND SCREENSHOTS
OFFICE VIEW, VITALS, CHIEF COMPLAINT, CURRENT MEDICATIONS, ALLERGIES,
ENCOUNTER SCREEN, PHYSICAL EXAM, ASSESSMENTS, TREATMENTS,
PRESCRIPTIONS, BILLING APPROVAL, WORKPLAN (PROCESS DEFINITION) EDITOR

Management

OUR MANAGEMENT TEAM RESUME
GREGORY D. VACCA, CEO & PRESIDENT
FRANK MARTIN, COO
MARK COPENHAVER, CTO
CHARLES WEBSTER, MD, MSIE, MSIS, CMIO
KATHLEEN ST. JOHN, JD, GENERAL COUNSEL
BETH PATE COPENHAVER, DEAN, EncounterPRO UNIVERSITY

Contact Info

 
HIE / Interfaces
 

EncounterPRO Healthcare Resources
2000 RiverEdge Parkway
Suite GL 100A
Atlanta, GA 30328
(800) 677-5653

www.encounterPRO.com
info@encounterPRO.com

EncounterPRO Healthcare Resources is a wholly owned subsidiary
of WifiMed Holdings Company, Inc. (OTCBB: WIFM)


The High-Usability EncounterPRO Pediatric EMR Workflow System Website
" Clinical Groupware for Pediatric Practice"
Under the Creative Commons Attribution 3.0 License
© 2009 EncounterPRO Healthcare Resources, Inc.

Use of EMR workflow systems, EMR groupware, clinical groupware, EHR workflow management systems, and EMR/EHR business process management frameworks and technologies will be key to transforming healthcare at the industry, organizational, and professional and personal levels. Subject to the Creative Commons Attribution 3.0 License, feel free to use content from this website and associated blog in educational curricula, industry presentations, websites, blogs, and social media.

Please attribute EncounterPRO Healthcare Resources, Inc. as the creator of this work. Please indicate the title of the Work: The High-Usability EncounterPRO Pediatric EMR Workflow System. Please include this URL for the Work: www.encounterPRO.com.

Additional Instruction

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