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Using File Explorer, file structure, and creating new charts

 

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Windows comes with a very powerful file structure utility called File Explorer that is linked to Windows Internet Explorer. You should familiarize yourself with this as much as possible if you aren't already. How you use this or if you use it at all will depend on whether or not you already have an EMR and how you plan to use the forms in your practice. For practical considerations, go here.

If you're just going to "link" the charts to your existing EMR software, then you don't need to know any of this and your EMR provider will set up the links and the directories where the files will be stored.

If you don't have an EMR, the next consideration is if you will be converting to all digital or only using the forms electronically and how you will be using them.

If you're planning to convert to all digital, you'll want to set up your patient file structure (read about the Paperless Office here). Depending on where the charts are going to be kept, a folder named something like Patient Files needs to be created. That's where all your patient files will be kept. If you're going to use Paperport, the Patient Charts folder can easily be linked to PaperPort through Tools / File Manager.

Then you'll want to create and set up a subfolder to Patient Files that will be used for each new patient. You can call this new folder New Patient. In the New Patient folder, you'll want to create several subfolders depending on how you like to organize your charts. You may want to keep your progress notes in the main portion of your New Patient folder so you won't have to create a Progress Notes subfolder. That way, when you select the individual patient's folder, you'll automatically be seeing the Patient's progress notes. You may however want to organize your patients' charts by storing labs, x-rays, ultrasounds, hospital information, personal and insurance information, consents, consults, etc. in separate subfolders. How you organize you charts is completely up to the individual user. Imagine the number of dividers you would have buy in order to accomplish this with paper. You will then want to populate the subfolders with any files that you may want available for each new patient; e.g., you may want a New Patient Evaluation form in each of the main portion of the New Patient folders so that you won't have to copy them individually for each patient or if your practice is almost all obstetrics, you may want a copy of the SmartOB Prenatal Forms in there as well. This folder will serve as your New Patient folder template.

The screen above is an example of  the file structure for patients as seen in Paperport. This allows you to work with digital charts as you would with paper, only more efficiently. Once the pregnancy is completed, Paperport enables easy conversion of the Excel based SmartOB Prenatal Forms to .pdf format and then simply STACKED (as with paper) on top of the Notes.

After you set up your default New Patient Folder template, you'll want to create many of these. If you're following along and actually doing the above, you should by now have a folder named Patient Files containing a subfolder named New Patient which in turn contains many subfolders and and files of your choice. Now it probably took you just as long to create this folder (or patient chart) as it would to assemble the materials, create and label a paper patient chart. But imagine how much effort it would take your office personnel to assemble a thousand more of these. You are now going to create charts for 10 new patients. Click on New Patient so that it is selected. Hit the key combination Ctrl-Insert (Ins on some computers). Now, while holding the Shift key down, hit the Insert (Ins) key 10 times as fast as you can. You now have 10 new charts labeled something like "Copy of New Patient" or "Copy (2) of New Patient." How much would it cost in time and material for your office personnel to accomplish the same task? The same technique is used to create multiple copies of the SmartOB Prenatal Forms template that you created.

Then you will rename one of them for each new or existing patient whose chart you plan to digitize. Your naming convention is a personal choice and may be similar or identical to the one you're already using. I use a unique number for each patient that was generated by my billing software followed by the patient's name. You may choose to use patient name followed by DOB. Whatever you choose, your charts will be organized by that naming convention in Explorer. If you use a numeric system and want to quickly find a patient by name, you can select the Search button on the toolbar above and enter the name of the patient in the search field.

You could keep the name of each copy of the SmartOB Prenatal unchanged; i.e. "SmartOB Prenatal Forms v2...", but that wouldn't help you identify individual patients in certain circumstances. For example, you want all the Obstetrical patients with due dates less than a certain date quickly and easily sent to the hospital through E-mail. You could Search for "SmartOB Prenatal Forms" and you would get all the files matching that description. But you wouldn't be able to tell which file corresponds to which patient or their due date. I suggest renaming each set of SmartOB Prenatal Forms used something similar to EDD, Name of Patient, Patient Number, "OB" (e.g., "2006-12-10 Jane Smith 2104 OB"). That way when you search for OB, all the OB files will be returned with the EDD ordered. When you then create your E-mail to the hospital, you can select all the charts that you want attached in one step. It doesn't get more efficient than that unless you're accessing the charts through the Internet (to do that go here).

All of the above applies no matter where you are storing your electronic charts. The charts may be on an office computer that is always running, a peripheral hard drive, a USB Flash drive or a Laptop computer that you always take with you. The file structure will remain the same. However, if you're just planning to use the SmartOB forms electronically and retain your paper charts, you will only need to create one folder (as described above) and keep all your prenatal charts there.


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Last modified: 04/23/09