Patient Reminders

MU Requirements

Meaningful Use Measures:

Reminder sent to at least 50% of all unique patients seen by the EP that are age 50 or over.

Certification Criteria for EHR:

Electronically generate, upon request, a patient reminder list for preventive or follow-up care according to patient references based on demographic data, specific conditions, and/or medication list.

From CCHIT:

1. AR.EP.N.1 The technology shall have the ability to send reminders to patients per patient preference for preventive/follow up care.

See Clinical Decision Rules for usage/application.

Proposed Solution

1. Create a rule-based patient reminder system for #1. The reminders are sent to provider's Messages box, which are then route to the patients.

2. A patient reminder can be sent in three ways: phone call, email, and/or by letter. The settings can be found in Patient Demographic, Choices section.

3. Integrate patient reminder with Maviq VOIP service to do automated phone calls. This is done using an API. Why VOIP? Because it costs about $1 to mail a letter, while an automated VOIP call is $0.10. The remainder schedule can also be controlled more precisely.

4. No reminder messages will be sent to provider's Messages box. This is to avoid overwhelming them with unwanted messages. However, the provider can print/view from Patient Reminders.

5. Integrate patient reminders with clinical alerts. Any past due and incomplete reminder will trigger an alert in Encounter Form together with other alerts.

Effected Code, Tables, etc

The proposed database table is as follows. It works with Clinical Decision Rule.

-- -- Table structure for table `patient_reminders` --

DROP TABLE IF EXISTS `patient_reminders`; CREATE TABLE `patient_reminders` (

`reminder_id` bigint(20) NOT NULL auto_increment,
`reminder_name` varchar(255) DEFAULT NULL COMMENT 'flu shot, smoking cessation',
`patient_id` bigint(20) DEFAULT NULL COMMENT 'id from patient_data table',
`scheduled_date` date DEFAULT NULL COMMENT 'cron job will be used to generate the reminders daily',
`reminder_content` longtext,
`sender_name` varchar(255) NOT NULL default ,
`email_address` varchar(255) NOT NULL default ,
`phone_number` varchar(255) NOT NULL default ,
`enroll_id` bigint(20) DEFAULT NULL,
`action_id` bigint(20) DEFAULT NULL,
`date_modified` date DEFAULT NULL, 
`status` varchar(255) DEFAULT NULL,
 PRIMARY KEY (`reminder_id`),
 KEY `patient_id` (`patient_id`)

) ENGINE=MyISAM AUTO_INCREMENT=1;

-- --------------------------------------------------------

Owner and Status

Design and coding - Thomas Wong (Intesync)

API for a automated VOIP solution - Yijin Woo (Maviq)

Status as of 2/4/2010: The work is 100% done.

Links

• CCHIT_MU_2011_Project
• Associated with Sourceforge forum thread:
  • http://sourceforge.net/projects/openemr/forums/forum/202506/topic/3531568 (CCHIT - Patient Reminder #2 (most recent))
  • http://sourceforge.net/projects/openemr/forums/forum/202506/topic/3496597 (CCHIT - Patient Reminder #1)
  • http://sourceforge.net/projects/openemr/forums/forum/202506/topic/3521158 (Emailing Mechanisms)
• PHPMailer: http://phpmailer.worxware.com/