Interdisciplinary Notes Interdisciplinary notes consist of individual progress notes Each individual note is attached to a parent note Each interdisciplinary note is displayed as a single entity

Interdisciplinary Notes Each part of the interdisciplinary note has a single author Interdisciplinary notes are not addendums Each entity of an interdisciplinary note can have a different title-this differentiates them from addendums You can add an addendum to an interdisciplinary note

Interdisciplinary Notes Interdisciplinary notes can have a template assigned to them, whereas an addendum cannot have the template populate automatically You can assign business rules to each title Parent/child notes

Interdisciplinary Notes 24 hour Shift Note could be set up as interdisciplinary notes The initial visit is the 1st shift of the day The other shifts are added as child notes They are kept in one folder Other inpatient notes are not added to the parent note

Interdisciplinary Notes Another example, using multidisciplines: Plan of Care notes Nurse begins note with initial plan of care Dietician adds first child note Other disciplines (respiratory therapy, spiritual care, pharmacy) add additional child notes

Disadvantages of Interdisciplinary Notes The author of the parent note is the author displayed first Author of the parent note needs to do his/her note first so others may be attached Set up is more involved than regular progress notes

Set-up of Interdisciplinary Notes Parent note Set up ID parent document class and ID child document class Some facilities name all ID notes starting with ID so they are easier to find Set up business rules Parent note must have business rule to allow attachments

Example of Business Rules for ID Parent Document Class

Example of Business Rules for ID Team Document Class

Set up of ID notes, cont. Add note titles to appropriate document class Attach templates to document titles if desired Training

Writing Interdisciplinary Notes Parent Note Select “New Note” Select parent title Complete template, if available Sign note

Writing Interdisciplinary Notes Child Note Open parent note Either right click or select “Action” Select “Add New Entry to Interdisciplinary Note” Select child note title Complete note and sign

Completed Notes Appear in Folder

Attach Completed Child Note to a Parent Note If the child note is completed prior to the parent note, it can be attached at a later time by clicking and dragging it to the parent note. The following message will display:

Display of ID Notes EHR displays all notes in the Interdisciplinary Note reference date order unless one of the child notes is selected. In this case, EHR displays the child note, then it displays all the notes in the Interdisciplinary Note reference date order; repeating the current note. In all other respects, the format of the display is the same as a regular note. The display of unsigned notes depends upon the business rules in effect at your site. These rules may allow you to view the unsigned child notes of other providers in the context of an Interdisciplinary Note. This is up to your local authorities.