Comments for North Dakota Health Information Technology http://www.healthit.nd.gov Quality Healthcare for All North Dakotans - Anywhere, Anytime Thu, 25 Oct 2012 12:17:07 +0000 hourly 1 http://ndstateblogs.edutech.nodak.edu/?v=3.1.2 Comment on VHR User Access Discussion by Lois Freisleben-Cook http://www.healthit.nd.gov/members/domainworkgroups/clinical/vhr-user-access-discussion/comment-page-1/#comment-22974 Lois Freisleben-Cook Thu, 25 Oct 2012 12:17:07 +0000 http://ndstateblogs.edutech.nodak.edu/healthit/?page_id=2079#comment-22974 I would agree that pharmacists should have greater access. Discussion about RN access would be nice as our RNs carry a lot of clinical responsibility for care coordination. Our clinic has a full time care coordinator for children with special health care needs whose responsibility includes coordinating information from various sources and arranging consults, transfer of pertinent information and retrieval of consultant findings for the medical home record. For this individual I see level three perhaps. I would agree that pharmacists should have greater access. Discussion about RN access would be nice as our RNs carry a lot of clinical responsibility for care coordination.
Our clinic has a full time care coordinator for children with special health care needs whose responsibility includes coordinating information from various sources and arranging consults, transfer of pertinent information and retrieval of consultant findings for the medical home record. For this individual I see level three perhaps.

]]> Comment on VHR User Access Discussion by Robin Iszler http://www.healthit.nd.gov/members/domainworkgroups/clinical/vhr-user-access-discussion/comment-page-1/#comment-22762 Robin Iszler Thu, 11 Oct 2012 17:44:58 +0000 http://ndstateblogs.edutech.nodak.edu/healthit/?page_id=2079#comment-22762 I think it looks good from a nursing stand point. I think it looks good from a nursing stand point.

]]> Comment on VHR User Access Discussion by Steve Clemenson, MD http://www.healthit.nd.gov/members/domainworkgroups/clinical/vhr-user-access-discussion/comment-page-1/#comment-22562 Steve Clemenson, MD Mon, 24 Sep 2012 22:40:21 +0000 http://ndstateblogs.edutech.nodak.edu/healthit/?page_id=2079#comment-22562 Looks good. I would say that pharmacist could have level 3 access like RNs. Not necessarily all physician functionality. Not pharmacy techs however! HIPPA issues Looks good. I would say that pharmacist could have level 3 access like RNs. Not necessarily all physician functionality. Not pharmacy techs however! HIPPA issues

]]> Comment on VHR User Access Discussion by Matt Paulson http://www.healthit.nd.gov/members/domainworkgroups/clinical/vhr-user-access-discussion/comment-page-1/#comment-22519 Matt Paulson Thu, 20 Sep 2012 20:05:20 +0000 http://ndstateblogs.edutech.nodak.edu/healthit/?page_id=2079#comment-22519 I feel pharmacists would benefit with access to Labs/Reports/ADT for DME claim processing and medication therapy management programs. I am not sure of what practice settings would benefit with access to radiology. I feel pharmacists would benefit with access to Labs/Reports/ADT for DME claim processing and medication therapy management programs. I am not sure of what practice settings would benefit with access to radiology.

]]> Comment on VHR User Access Discussion by Connie Geyer http://www.healthit.nd.gov/members/domainworkgroups/clinical/vhr-user-access-discussion/comment-page-1/#comment-22444 Connie Geyer Mon, 10 Sep 2012 15:47:59 +0000 http://ndstateblogs.edutech.nodak.edu/healthit/?page_id=2079#comment-22444 Pharmacists should have same access as physicians. Opportunities arise often (especially on call times) that the pharmacist may need to see physican notes, and more of the story to avoid medical errors, or miscommunications. I think they would also need query functionality at times. Nursing assistants need to be included in the levels. Their roles vary depending on the venue in which they work. Perhaps level 4 would be a good place to start. Pharmacists should have same access as physicians. Opportunities arise often (especially on call times) that the pharmacist may need to see physican notes, and more of the story to avoid medical errors, or miscommunications. I think they would also need query functionality at times.
Nursing assistants need to be included in the levels. Their roles vary depending on the venue in which they work. Perhaps level 4 would be a good place to start.

]]> Comment on VHR Lab List Discussions by Lois Freisleben-Cook http://www.healthit.nd.gov/members/domainworkgroups/clinical/vhr-lab-list-discussions/comment-page-1/#comment-22320 Lois Freisleben-Cook Fri, 24 Aug 2012 00:30:50 +0000 http://ndstateblogs.edutech.nodak.edu/healthit/?page_id=1720#comment-22320 Would like to consider lactate pyruvate quantitative urine organic acids quantitative serum amino acids carnitine/acylcarnitine profile Quantitative Immunoglobulins IgG subsets I agree with pulse oximetry for newborns at greater than 24 hours of age Stool lactoferrin stool reducing substances Celiac panel Celiac gene testing Would like to consider

lactate
pyruvate
quantitative urine organic acids
quantitative serum amino acids
carnitine/acylcarnitine profile

Quantitative Immunoglobulins
IgG subsets

I agree with pulse oximetry for newborns at greater than 24 hours of age

Stool lactoferrin
stool reducing substances

Celiac panel
Celiac gene testing

]]> Comment on VHR Lab List Discussions by Lara Lunde, MD http://www.healthit.nd.gov/members/domainworkgroups/clinical/vhr-lab-list-discussions/comment-page-1/#comment-21926 Lara Lunde, MD Thu, 19 Jul 2012 13:30:30 +0000 http://ndstateblogs.edutech.nodak.edu/healthit/?page_id=1720#comment-21926 I agree with Dr. Haugen's comments on eliminating the bicarb. I also feel that the vitamin levels, lipase, and INR levels should be included. I would consider adding a sedimentation rate to the Infection section as well. I am very concerned about the confidentiality issues related to HIV; however, if we have that figured out, maybe consider adding Gonorrhea/Chlamydia testing as well. I agree with Dr. Haugen’s comments on eliminating the bicarb. I also feel that the vitamin levels, lipase, and INR levels should be included. I would consider adding a sedimentation rate to the Infection section as well. I am very concerned about the confidentiality issues related to HIV; however, if we have that figured out, maybe consider adding Gonorrhea/Chlamydia testing as well.

]]> Comment on VHR Lab List Discussions by dan dalan http://www.healthit.nd.gov/members/domainworkgroups/clinical/vhr-lab-list-discussions/comment-page-1/#comment-21916 dan dalan Tue, 17 Jul 2012 18:24:29 +0000 http://ndstateblogs.edutech.nodak.edu/healthit/?page_id=1720#comment-21916 Immune related tests and serologies have been recommended, and we discussed this on the last Clinical work group meeting but would like to go on record here. Related to the immune responses and antibodies so far noted can be grouoped with an autoimmune work up such as rheumatology. Immunoglobulins A, G, M, E as well as complement levels C3 C4 CH50 can be tied in with this heading. Immune related tests and serologies have been recommended, and we discussed this on the last Clinical work group meeting but would like to go on record here.

Related to the immune responses and antibodies so far noted can be grouoped with an autoimmune work up such as rheumatology.

Immunoglobulins A, G, M, E as well as complement levels C3 C4 CH50 can be tied in with this heading.

]]> Comment on VHR Lab List Discussions by dan dalan http://www.healthit.nd.gov/members/domainworkgroups/clinical/vhr-lab-list-discussions/comment-page-1/#comment-21915 dan dalan Tue, 17 Jul 2012 18:22:30 +0000 http://ndstateblogs.edutech.nodak.edu/healthit/?page_id=1720#comment-21915 Glucometer reeadings are important in management, and other MD's may want to comment. On a personal side and as a physician, these values are edifying and can motivate for healthy change. The caveat is trust but verify. The validity of the readings is important and should be considered as personal health records PHR, and only until they are validated by the health care facility, MD and others should they become part of EMR then NDHIN. So the glucometer readings if from patient should be treated as PHR, and as such identified. Making medical decisions on incorrect readings will be an unintended consequence. So for now, they may not belong to this site. Glucometer reeadings are important in management, and other MD’s may want to comment. On a personal side and as a physician, these values are edifying and can motivate for healthy change.

The caveat is trust but verify. The validity of the readings is important and should be considered as personal health records PHR, and only until they are validated by the health care facility, MD and others should they become part of EMR then NDHIN.
So the glucometer readings if from patient should be treated as PHR, and as such identified.

Making medical decisions on incorrect readings will be an unintended consequence.

So for now, they may not belong to this site.

]]> Comment on VHR Lab List Discussions by Debra Geier http://www.healthit.nd.gov/members/domainworkgroups/clinical/vhr-lab-list-discussions/comment-page-1/#comment-21867 Debra Geier Tue, 10 Jul 2012 18:08:40 +0000 http://ndstateblogs.edutech.nodak.edu/healthit/?page_id=1720#comment-21867 please include troponin I and troponin T. Agree with need for urine culture results please include troponin I and troponin T. Agree with need for urine culture results

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