For some time now, our office staff have been organizing their charting templates in Practice Fusion in the same manner in which we were all initially trained: (1) Navigate to your Settings menu, then (2) navigate to the Template Library, and (3) choose Sort alphabetically or Sort manually from the drop down menu.
However, more recently one of our staff members discovered a more intuitive method of organizing our charting templates. Read below to discover this and some other useful tips that we have discovered over the years.
In general, you find that when creating an encounter it is difficult to locate your charting templates.
QUICK TIP #1
When creating a charting template, precede the template name by a category that you are familiar with.
Then, go to Settings and your Template Library and choose the option Sort Alphabetically.
When writing a SOAP note, all of your template line items are visible and easy to access, however many of these template line items disappear when writing up an H&P, or any other Note Type where there is only one text field.
QUICK TIP #2
By default, all charting templates have template line items (text fields) within each SOAP note template sections.
Therefore, when you’re composing an H&P or any other chart type with only ONE field, then the only way to view and utilize all template line items of a SOAP note template is to copy and paste all template line items of your SOAP note template (i.e., line items from sections O, A, and P – Fig. B) into the S or SUBJECTIVE section. (Fig. A)
Your new charting template can now be used in both a SOAP note and in an H&P note (or any note type with one field).
Before you go: Check out this article here from Practice Fusion regarding some advanced features to customize your template line items.
Comments? Tell us what you think? Feel free to offer additional insight on how your practice streamline’s Practice Fusion’s EMR.
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Ebola hemorrhagic fever, now called Ebola Virus Disease (EVD) is considered a bio-safety level IV agent, the most dangerous agent known to man. Bats are known carriers of Ebola and have likely played a role in the critically endangered state of our oldest living relative–the great ape. Ebola is spread through the blood or bodily fluids of infected individuals. The 2014 Ebola outbreak is thought to have stemmed from a 2 year old child in southeastern Guinea who played in a tree where Ebola-infected bats lived; he died in December 2013.
Cases of Ebola have been around for quite some time. In fact, Ebola has its origins in ancient times, thousands of years ago when it split from different virus families. The CDC’s historical timeline lists a multitude of Ebola reported cases starting in 1976. Epidemiologists and scientists have long warned of further outbreaks.
Viral mutations may play a large role. The most recent outbreak of Ebola in March of 2014 was the Zaire strain, one of the most virulent and pathological. The least virulent (Reston) has been identified in the Western Pacific. To date, infected persons are relatively asymptomatic and no human deaths have resulted from the Reston strain.
As of January 16, 2015, there have been more than 21,000 reported human cases of the Zaire strain. More than 8,400 of these cases have resulted in death. This is in stark contrast where Uganda in the early 2000’s reported 425 cases with reported deaths listed as 224. Until the current outbreak, the Uganda outbreak was the highest number of reported cases since 1976.
Endemic or Epidemic? What’s the difference?
An endemic is described as disease that is restricted to a certain geographic region or area. An epidemic describes disease that effect a large percent of the population all at once. This is the first time Ebola has been spread through air travel yet it remains what many have called an unprecedentedepidemic. What most people today are probably concerned about is known as a pandemic. A pandemic is defined as the spread of disease over a large geographic region affecting a significant number of the population.
How worried should I be?
Ebola is less contagious than other infectious diseases, such as measles. NPR’s Michaeleen Doucleffe demonstrates how quickly sick individuals can infect others. For instance, for every one person infected with Ebola two others can catch the disease. However, in the case of measles, for every one person infected with measles 18 others could potentially contract the disease. These 18 individuals could infect many more in a population than Ebola could.
However, the mortality rate, or chances of dying when infected with Ebola is somewhere between 25 and 90%. Death typically ensues after massive fluid loss occurs (due to diarrhea, vomiting, and sometimes blood loss). No known cure exists for Ebola to date. The mainstay of treatment is supportive in nature and includes the use of intravenous fluids which has in fact helped save lives.
What is the future of Ebola?
Canada has had a long history of research in developing an Ebola vaccine. Human trials began this past October 2014 (VSV-ZEBOV vaccine) with phase III clinical trials occurring in West Africa, currently. More research is required for earlier detection, diagnosis (such as rapid point of care testing), and treatment protocols to further alleviate the symptoms of those afflicted with Ebola. Methods to anticipate and prevent the evolution and mutation of all Ebola strains are especially necessary in pigs, as they are the ideal host for virus mutations to occur.
What can I do?
Most people develop a sense of helplessness during disease outbreaks. Fear leads to irrational irrationality, while individuals try to find ways of regaining control of their and their family’s health and well being. This is especially the case during public health crises.
Educating yourself can help to alleviate some fears on public health threats. Ignorance is not always bliss. Rallying the efforts of local thought leaders and stakeholders to implement preparedness strategies as recommended by the CDC can help you feel more in control of your surroundings.
Community involvement in state and local public health preparedness initiatives can help influence policy makers to prioritize the appropriation of federal dollars for such causes. For more information on your state’s initiatives on public health preparedness, contact your elected government official. For other ways to help, click here.
January marks Cervical Cancer Awareness Month. The Centers for Disease Control and Prevention (CDC) tells us that cervical cancer is curable with routine screening and medical follow up. Cervical cancer screening is now so efficient that the CDC reports that no one should ever die from cervical cancer.
So…why are we talking about this?
Cervical cancer is a preventable cancer, but many of our friends and family members fail to schedule their routine cervical cancer screening with their medical provider. The CDC reports that over the last five years, over 8 million women ages 21 to 65 have failed to get screened!
Almost 2 million of these women failed to do so because they either did not have a primary care provider (PCP) or were uninsured. It’s not a surprise, then, that more than half of all documented cervical cancers are found in women who have not been screened within the last 5 years.
How can I make sure I don’t get cervical cancer?
All women ages 21 to 65 should have a yearly women’s wellness exam with scheduled Papanicolaou (Pap) and a Human Papilloma Virus (HPV) tests as directed by their medical provider. A medical provider or primary care provider (PCP) can be your designated nurse practitioner, physician or a gynecologist. Your PCP performs a Pap and HPV test in order to prepare cells taken from your cervix to send to a lab to test for cervical cancers.
But is it painful?
There is some mild pressure during the pelvic exam and Pap test, but it should not be painful. Not sure of what a Pap test is? Find out more through Medline’s interactive tutorial on how your PCP performs a Pap test.
Where can I get screened?
Your PCP is someone who is recognized or assigned by your medical insurance – the good news is this could be your very own nurse practitioner! He or she can perform your Pap test and will refer you to a gynecologist (if necessary). Preparation for your exam is fairly simple; the National Cervical Cancer Coalition has some great tips.
Is there a vaccine involved?
Yes, there is a vaccine for HPV called Gardasil. Young children, both male and female should get the vaccine from their medical providers between the ages of 11 or 12; young adults up to the age of 26 years are also eligible.
To see if you qualify for surprisingly affordable vaccines, you can call the Associates in Health & Wellness office or go to the CDC website.
How often should I get screened?
Screening should be done anywhere between one and three years or more, depending on your age and risk factors; unless your PCP or gynecologist recommend otherwise. Enter these dates into your calendar or set a repeating reminder if you’re using an electronic calendar. It is that important! Don’t forget to schedule your Pap test ahead of time to ensure you don’t forget.
Have more questions?
Want to speak to one of our nurse practitioners today? Send us an email, follow us on Facebook or Twitter or give us call at 844-551-6710; someone will return your call within 1-2 business days. You’ll find a 24hr or less turn around time with email.
“US Not Making the Grade on Cervical Cancer Screening” Medscape. WebMd LLC, CDC Vital Signs, 11/1014.
“Cervical Cancer: Practice Essentials” Medscape. WebMD LLC, n.p., 8/2014.
“Cervical Cancer is Preventable: Too Many Missed Opportunities” Medscape. WebMD LLC, Ileana Arias, PhD. January 05, 2015.
“X-Plain Patient Education: Pap Smear” Medline Plus. n.p., n.d.
“Cervical Cancer” Mayo Clinic. Mayo Clinic Staff, n.p., 12/11/14.
“Screening: Pap and HPV tests” National Cervical Cancer Coalition. n.a., n.p.
I read an article the other day, somewhere online in which the author suggested several things to do, daily in order to remain productive in your professional career. The author mentions posting several or more industry based content to all your social media accounts, including networking, completing several goal oriented tasks, locker-room chit-chat, etcetera. Didn’t the author mean all in one week, I thought? I had to look back at the title. Are they really that productive? Aren’t we all just hooked-up to intravenous caffeine running through our veins while burning a candle at both ends? No?
Well, I personally can’t seem to catch my tail. I’m overwhelmed with lists and to-do’s. I refrain from posting stickies but tasks find their way into my everyday life, even obstructing my sleep through apps that beep, LED lights that flash and emails that chime. I wonder which app or program was it that convinced me to integrate all these GTD apps onto every personal wireless device or tablet that I own? Was it IFTTT? Or was it the native app, itself? I can’t seem to recall.
Nevertheless, I decided to take a closer look at the root of the problem and soon realized that perhaps there are people out there who don’t find it part of their daily religion to procrastinate. In my case, when I procrastinate, I perform meaningless, mindless activities such as organizing papers, filing, shredding, surfing the web and the like. I realize that I am ultimately wasting away my day but somehow can’t seem to control myself, like some mindless, wide-eyed, giggling robot that gets a kick out of sorting mail into “urgent”, “scan” and “follow-up” piles; as if I’ll really get around to doing these things. But for some reason I find these tasks less daunting than what the required tasks at hand have in store for me. I seem to find these mindless tasks immediately gratifying, perhaps even rewarding?
Maybe so, according to Dr. Chrisoula Andreou, Associate Professor in the Philosophy Department at the University of Utah. In her article Understanding Procrastination in the Journal for the Theory of Social Behaviour, the author states that “compared with an aversive task, a merely boring chore counts as relatively rewarding” (p. 185). The author goes on to describe that as animals, we forgo “future utility” in order to gain personal satisfaction in the present. I think I’ve heard of this before somewhere.
Dr. Andreou explains how past studies prove that the closer a smaller reward (e.g. watching a TV show), the more likely we will succumb to that smaller reward. However, if the larger reward is nearer, (e.g. imminent deadline for the completion of a novel), the more likely we will complete the larger reward. However, let’s say that the larger reward gets pushed off to the future again (e.g. novel completion deadline gets extended another month), then the smaller reward (e.g. watching that TV show) seems much more rewarding again. (This is so me.) The author describes this phenomena as preference reversal and demonstrates this on discount curves; a discussion beyond the scope of this post.
In identifiying the root of the problem we procrastinators can avoid self-deprecation and gain faith in our abilities to be productive. Any advice so far? Well, Dr. Andreou recommends imposing strict deadlines that hold high repercussions (e.g. financial penalties or verbal commitments to friends and family) to the procrastinator since this technique has been shown to improve productivity.
It looks like my filing will have to take a back seat. Oh, the horror.
Andreou, C. (2007). Understanding Procrastination. Journal for the Theory of Social Behaviour, 37(2), 183–193. doi:10.1111/j.1468-5914.2007.00331.x