User Support Newsletter... December 4, 2003




12/4/03 Meeting Highlights
Eighteen CDEMS users from 12 WA clinics attended the first CDEMS User Support Meeting in Kent, WA on December 4, 2003. Participant were: Heidi Martinez (Yakima Valley Farmworkers Clinic), Ming Eng (Puget Sound Neighborhood Health Clinic), Sheila Peel (Pacific Medical Center), Shonnie Evans (Country Doctor), Sandra Hawkinson (Swedish Physician Division), Cathy Irby & Jean Gambrielle (Northwest Physicians Network), Jackie Vasquez , Francisco Arias & Guillermo Izquierdo (SeaMar), Dawn Corl, Shannon Bailey, & Elizabeth Arant (Pike Market Medical Clinic), Hollie Floen (Community Health Centers King Co.), Colette Rush & Jesi Ogo (Polyclinic), Gail Edmonson & Lauri Luepke (Vancouver Clinic)

Dawn Corl, Diabetes Coordinator at the Pike Market Clinic in Seattle was the guest presenter. Dawn described the Stars Awards program implemented at her clinic to motivate and reward patients who achieve difficult diabetes control benchmarks.

The presentation covered many aspects of the program from technical creation of CDEMS queries identifying eligible patients to development of community resource partnerships to summarizing clinical outcomes. The program is indeed a motivator as demonstrated by awards to 15 "ideal control" patients during the first year. Ideal control is defined as HbA1c<6.2% in the last six months and LDL<100 in the last 12 months. In the previous year, registry analysis showed 0 patients in the ideal control category.

We thank Dawn for an inspiring presentation and for the best quote of the day:

"We could never ever have done this (Stars Awards Program) without a registry!"
A lively interactive user discussion followed on many topics with highlights and questions & responses detailed below. The meeting ended with a quick demonstration of the CDEMS Tickler setup.



Discussion Topics
General topics discussed at the the meeting:
  • Integrated tracking of multiple conditions in CDEMS ~ multi-purpose planned chronic care visits
  • Inactivating a health condition for an active patient in CDEMS
  • Issue of last height not shown on current progress note
  • Health condition start date versus registry start date


Information/Q & A Response Links
Many questions and issues were raised during the meeting and during the informal conversations following the meeting. Below are key questions addressed at the meeting with links to answers posted in the CDEMS User Forum:
  • Click Stars Queries for a link to instructions on the User Forum for creating the custom Stars Awards queries.

  • Double-click on Stars Awards Presentation to download Dawn Corl's PowerPoint slide show. Open the file to your desktop or save it in a temp folder. Click on PMMC_Stars.ppt > click Self Extract in menu bar > Extract File > Execute > then open the unzipped file. To print the slide show in "handout" format, click on File > Print > select Handouts in the "Print What" box > set "Slides per page" to 6 > OK

  • Click Tickler Setup Guide for a copy of the Tickler setup handout.

  • Q #1 - How can blank pages be eliminated when printing progress notes?
    Click Eliminate Blank Page for related Forum discussion.
    Click Other Printer Adjustments to link to Forum discussion of print adjustments.
    Click Re-align Form for additional discussion on form alignment.

  • Q #2 - Can the shading be turned off for labs/services referred and completed in the same day?
    Click Same-Day Referrals Completed link.

  • Q #3 - How can I allow my receptionist to print progress notes but not enter or alter data?
    Click Print Only Access to CDEMS to link to Forum solution.

  • Q #4 - Why does the PCP filter not work in the Master Template for New Lists?
    Click Malfunctioning PCP Filter to see the Forum discussion.

  • Q #5 - Is it possible to display labs and services in a different order on the progress note?
    Yes! Labs and services can be displayed in any sequence you'd like by re-numbering items in tlkpSetup. Click Re-order Labs & Services to link to Forum instructions.

  • Q #6 - What is the std_alert field used for in the Tickler setup?
    Click Std-Alert Field to link answer in User Forum.

  • Q #7 - After highlighting a patient to edit from the inactive list, an error message says that a patient has NOT been selected. How can I access an inactive patient record for editing?
    Click Edit Inactive Patient for a possible solution.

Deferred Issues:

  • We seem to be losing data between multiple users on the two computers using CDEMS in our clinic...

  • Aggregating data
    There is an Access program under development called "grouper.mdb". Grouper is put in a folder with all the other cdem_dta.mdb files that you want to aggregate. The program opens the first file and uses that as a master then appends sequentially every additional file in the folder to the master. It needs to be a repository for all the items in every client file so consistency across the incoming files is necessary to make it useful. Certainly don't use the same raw_code in two different clinics for different items. For instance don't use the raw code of "Stest" in one clinic for spirometry and then store values for a stress test as "Stest" in another clinic. That'd combine the apples and oranges without any warning to the interpreter. Click e-mail Dusty if you're interested in working with him to test the Grouper program.


Survey Results
Thank you all for offering valuable feedback to help us improve this meeting format to better meet your needs. Here's a sample of what we learned from the survey responses:
  • Most users were interested in meeting 3-4 times/year.
  • Users were evenly split in their preference for half and full-day sessions.
  • Hot topics for future meetings:
    #1 - CDEMS maintenance (data cleanup, compact & repair DB, file backups)
    #2 - Troubleshooting techniques
    #3 - Setting up a new health condition
    #4 - Creating custom reports program
Next User Support Meeting: March 4, 2004 in Kent, WA