Wednesday, July 30, 2008


Flowsheets, the systematic recording in chronologic order of findings and facts about a particular patient, are a great way to maintain and improve the quality of care - especially for patients with chronic disease. Doctors (and other providers) love to have flow sheets - but they hate to make them. Personally, I spend a huge fraction of every day in the clinic updating the lists with medications, vital signs, lab results, etc.

One of the main stimuli for developing the Vermont Diabetes Information System was to lessen the burden of keeping the flowsheet. It started back in the early '90s when Charlie asked the lab at our hospital to make flowsheets of the key lab results for patients with diabetes. That simple idea evolved over more than 10 years and two NIH grants into an automatic system that includes the patient's test results no matter which laboratory they use, and provides guideline based advice to the primary provider to help them stay organized. Here is the current version:

(A full size pdf file is here.)

It arrives in the office the morning after the lab test is done - often before the official lab report. And, it has more than just the latest result for a single test - it has the last 4 results for all of the major diabetes tests plus advice based on the American Diabetes Association guidelines. The doctors and nurses liked these "value-added" laboratory reports and they became the basis for other HIE-based products and services which I will write about soon.



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