One of my favorite things to do during the now “forbidden” annual visit, that Medicare finally decided to reimburse, starting in 2011, is reviewing the health maintenance and immunization status.
During annual wellness, with the large TV screen glaring the information to the patient and my voice echoing the visual on the screen, and my fingers dancing on the Chromebook, I make a circular trip through the patient’s chart.
First with reviewing graphed out BMI, blood pressure and weights, then updating past medical, social, family histories, and updating meds and allergies, then graphed out HL7 lab results.
But the really cool trick the EHR does from a software perspective, is when I click on the DECISION SUPPORT key. The age, gender,and diagnosis codes are intertwined with US Task Force and CDC guided Immunization recommendations. Up pops a visual, and I tell my good patient, now you can make sure I am doing my job, this is intended only for my eyes, but lets go over this together so you know I am staying on task.
So, this red bar means you are overdue for Shingles vaccine, now that you are over 65 you better have that done at one of the local pharmacies, it will cost you less, so sorry about that. I see that on the Annual Medicare Wellness Survey your answers were negative on questions concerning depression, but this yellow bar here reminds me to discuss this with you, any problems there?
So we go down the list, but projecting this information and reviewing, is extremely helpful and serves both physician and patient well, and despite the Cochrane study regarding the folly of the annual wellness visit, even if the reimbursement is taken away, I will continue to do, because it is the right thing to do for my patient. I did it for years without reimbursement, I figured this would be transitory, but such is life in the trenches.