OpenDoorDocs.org

Urban Ministries of Wake County

Open Door Clinic

Provider Support & Guidance

Updated:
September, 2013
Gary Greenberg, MD
(email )

Schedules

Maps

Forum

    Intro

Web Links


Clinical Forms, Tools

Maps:

    Current (new!) clinic site: is at 1390 Capital Blvd, Raleigh, NC 27603. The linked map shows not only the location, but the view from the street.

    This schematic below may also help.

 

  

Schedules:

    Open Door Clinic Staffing Calendar  (please open "Volunteer Schedule for … months"

 

  

Forums & Discussions:

Please, please enroll your email address here. Our hope is to use a simple outreach email list to provide operational and clinical updates to our community of providers. You should expect to learn about such issues as:

  • Clinical tactics for optimized use of the clinic’s resources
  • Availability of specific consultations via Project Access
  • New plans and policies for the clinic’s operations
  • Changes in the clinic’s procedures, stemming from:
    • new location
    • new daytime operations,
    • new paid daytime staff,
    • new linkages to other "safety net" community resources
  • Pharmacy issues
    • Medication availability
    • Needs for specific sample meds
    • Replacement policies within medication classes
    • Prescribing policies

    Subscribe for announcements only:

    Archives for announcements


A second forum is being established for discussion, and not merely announcements. Here, the intent is to provide a virtual community for developing consensus, seeking help and providing support for practitioners delivering care that might prove uncomfortable. Our practice includes both specialists providing care outside their usual scope and retirees resuming active service… and many of our partners are likely to find advantage in the opportunity to ask for help and ideas regading modern standards of care. When possible, citations to published resources will be provided (by Dr. Greenberg) so the forum reflects current standards and not merely local consensus.

    Subscribe for discussion:

    Archives for discussion (approval required, contact Gary Greenberg)

 

 

 

Web Links for Clinical Needs:
Standards of Care:

Resources for recommended care for chronic disease

    Diabetes:

      Standards of Medical Care in Diabetes—2010 ADA recommendations for DM management, 51 pages in all

      Medications for Treatment of Hyperglycemia, ADA & Euro. Assoc. for the Study of Diabetes’s treatment protocol, before the general Standards publication, above. Diabetes Care 32:193–203, 2009, 11 pages

      ADA’s topical Recommendations, regarding non-clinical issues

      Community Care of N. Carolina (NC Medicaid’s 5-page guidance consensus document) for Diabetes

      California’s CalOptima guidelines for comprehensive DM treatment

      Explanatory Powerpoint for presentation to NC Assoc. Free Clinic, 4/8/10, Greenville, NC, "DM-2 by the Rules"

       

    Lipids:

    Hypertension:

      JNC-7 Hypertension Guidelines, NHLBI / NIH Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)

       

    Asthma:

      Guidelines for the Diagnosis and Management of Asthma (EPR-3), August, 2007

      Maintenance therapy discussion, adults

      Managing Exacerbations

      Community Care of N. Carolina (NC Medicaid’s 4-page guidance consensus document) for Asthma

       

    Chronic Obstructive Pulmonary Disease

      Community Care of N. Carolina (Medicaid guidance consensus 3-page document) for COPD

     

    Congestive Heart Failure

      Community Care of N. Carolina (Medicaid guidance consensus 6-page document) for CHF

       

    Prevention / Screening:

      USPTF / AHRQ Guidelines to Prevention Recommendations for Care for Well Adults

      USPTF Pocket Guide to Clinical Preventive Services, 2006 Condensed guidelines for prevention management

     

    Smoking Cessation, "Tobacco Free" by Association of Clinicians for Underserved:

      Fact Sheets, Graphs, Data on use, quitting

      Handouts, including narrow audiences (minority, age-groups, HIV+, pregnant)

      Research data, tables

     

    Immunization Issues (& Vaccine Information Statements):

      ACIP (Advisory Committee on Immunization Practices) Adult Immunization Schedule, at the CDC, updated 1/2009

      Influenza: Recommendations, VIS: English, Spanish

      Hepatitis A: Recommendations,VIS: English, Spanish

      Hepatitis B: Recommendations, VIS: English, Spanish

      Pneumococcal Polyvalent Vaccine: Recommendations, VIS: English, Spanish

      Tetanus, Diphtheria, acellular Pertussis: Recommendations, VIS: English, Spanish

      Tetanus, Diptheria (old-style): Recommendations, VIS: English, Spanish

     

    Alzheimer’s Tests for Cognition / Dementia

      Printable form of Folstein’s Mini-Mental State Exam (MMSE)

      Newly validated Test Your Memory test (TYM) questionaire and scoring sheet

     

    Osteoporosis Scoring, Risk Calculation

      FRAX calculator, US-specific, but requires selection of race before use. These 4 categories share one URL.

     

    Tubculosis Testing

      State of NC’s recommendations during PPD solution scarcity, June 2013

      CDC’s Health Alert Network discussion, September, 2013

Patient Education:

    FamilyDoctor.org (AAFP, almost 100% available in Spanish)

    MedLine Plus (NLM, many links to other sites, variably translated)

    Web-MD (Tests, Diagnoses, Medications)

    Am. Coll. Rheumatology

    Am. Diabetes Assoc.

    DASH diet for hypertension (Spanish)

    Cardiovascular Disease Directory, NHLBI (English only)

    Am. College of Physicians’ Health TiPS (including Spanish for these 22 pages)

Cultural Assistance:

    WebLinks:

    Cross Cultural Health Care Program Ethnic & Language Tips for Cultural & Linguistic Challenges

    PolyGlot Spanish Language Phrases incl out-loud pronunciation

    Google Translator

    WorldLingo Language Translator

    AltaVista / BabelFish Translator

    Medical Phrasebook, Spanish (by California Office of Binational Border Health)

    Medical Spanish Training, with daily medical dialogues, vocabulary lists and audio for common phrases.

    Academic resources, Leslie deRosset, MPH’s powerpoint on impact of Hispanic culture & health issues

    Community Care of Wake & Johnston Counties offers several tools for networking and support. A document teaching the rules behind complex Spanish surnames is especially useful.

    Books:

    • The Latino Patient: A Cultural Guide for Healthcare Providers by Nilda Chong ($30 Paperback -2002)
    • Hmong culture & philosophical ideas: The Spirit Catches You and You Fall Down by Anne Fadiman ($10.50 Paperback 1998)

    Tapes / CD / Books / Courses for Spanish Language Instruction

    • Pimsleur Audio-only instruction (wonderful! and used versions are much cheaper)
      • Sampler (1st 10 lessons, $16.50)
      • Volume 1  of 3 (1st 30 or 90 total lessons, $217)

       

      • Wake Co Library listings, on CD, for FREE!:
        • Vol 1, part A & B
        • Vol 2, part A & B
        • Vol 3, part A & B

         

      • Audible.com offers very convenient electronic players’ downloadable versions, at $29 for each 5 lessons. That means Vol 1 (parts 1-6) will cost $171.30 both cheaper & easier than owning the CD’s. Audible will also sell you a subscription for up to a half-off any of their books, including these. If you contact me, we both get a discount for my referring you for their membership.

    • Learning Spanish Like Crazy is another well-organized, autio-based program thiat can be pursued while driving. It seems to offer more hours of instruction, and (better than Pimsleur) offers transcripts for each lesson at the company’s website. I don’t like the flow or content as much, but maybe I’m picky.

      • The trial lessons (1-2 hrs) are free and available via download. Price is still quite high UNLESS you choose to download the course from Audible, where members pay just 1 credit (~$10) for each $140 volume, and then are allowed to also receive bonus lessons as well. This seems a bookkeeping mistake by Audible’s site, so it may soon vanish. As above, if you contact me, we both get a discount for my referring you to their membership.


    • Destinos, An introduction to Spanish is an instructive TeleNovela (soap opera!) in Spanish. It is delightful, entertaining and well developed. There are also several workbooks and CD’s to buy in addition to watching the episodes for free on your PC. Here’s the opportunity to take the course for (!) College Credit via WUNC-TV’s distance learning program. In past semesters, the show has also been televised.

    • Coffeebreak Español, a free weekly podcast teaching Spanish. Mark helps Kara learn Spanish. Cheery, light, rather unstructured. Their English is entertainingly Scottish, and their Spanish is a bit distressingly Castillian (European), so the pronunciation sounds MUCH different than our patients’.

    • An Introduction to Spanish for Health Care Workers: Communication and Culture by Robert O. Chase and Clarisa B. Medina De Chase $40, (Paperback – 2002) Excellent text, with useful vocabulary, pretty detailed grammar, including exercises. The accompanying CD is useless.

    • Other courses are all worse. Ask me about:
      • Behind the Wheel Spanish (intro and verbs)
      • Michel Thomas Spanish

    Courses / Classes in Medical Spanish, RTP area

    • HISPAmericano Institute (Durham) small groups, 4 levels

     

    • Chapel Hill Institute for Cultural & Language Education CHICLE (Carrboro)

     

    • Wake Tech "Command Spanish" a non-academic, non-grammer, occupation-specific course designed and targeted for Business, Industry, and Non-Profit organizations.

     

Organizations for Clinical Care of Underserved Populations:

    Association of Clinicians for the Underserved

    National Association of Free Clinics

    NC Association of Free Clinics

    Project Access of Wake County Medical Society

     

  
Clinic’s Calendar

The link to the online schedule for volunteers’ assignments is near the bottom of this page.

Look for For current volunteer schedule, please click here (updated every Friday):

 

  

Forms / Documents

These forms are obsessively over-formatted, so are only available as Adobe Acrobat files. Display software is available without charge, here.

Volunteer entry documentation:

  • Volunteer application
  • Confidentiality form
  • Anti-Discrimination Policy
  • For those providers requiring to be added to the Urban Ministries malpractice coverage:
    • Physicians’ application form
    • Non-Physicians’ application form

Urgent DM Management Check-list and Guidance

Volunteer Recruitment Poster / Flyer

Referral forms to send patients to Open Door Clinic. These include instructions to clinician, and to the patient (both in English & Spanish)

Handicapped Parking Request Form (Print only the first page. You’ll have to choose temporary or permanent afterward)

Accessible Raleigh Transportation Program (ART)

    a paratransit system operating in accordance with the Americans with Disabilities Act (ADA) of 1990, is designed to serve individuals whose disabling conditions or functional limitations prevent them from using regular fixed route Capital Area Transit (CAT) [buses].  The Tier II program allows taxi or wheelchair accessible handicab trips to be made at the cost of $2.00 per trip for eligible users.

    Application form. Part A is for patients to complete. Part B requires physician signature regarding patient’s difficulties with:

  • mobility
  • endurance
  • visual problems
  • cognitive disability
  • a severe medical condition (other), including specific transportation needs:
    • need for a bench or shelter
    • trouble with weather conditions (eg windy, icy, too hot or cold)
    • difficulties with distance to bus-stop (home or destination)
  

Software Support, AllScripts Professional
 
Running AllScripts Professional EMR from home

Unavailable for PC’s running Macs and also for many using MicroSoft VISTA Operating Systems

    1) Using Internet Explorer (not FireFox or Chrome), browse to (& bookmark)

    https://prosuite.allscriptscloud.com/RDWeb/Pages/en-US/Default.aspx

    2) Enter your usual first.lastname login, with the standardized A/S cloud password (obscurred for the web):  WellnessUM#1 (or 2)

    3) Click on the "Clinical Module, East" icon. Sometimes it shows only the words, not the picture.

    4) If you get a box that blocks this step (or the next one) asking for new "Windows Security" Credentials, then repeat the initial *CLOUD* login, but this time, instead of using your first.lastname login, add this prefix and use the same Cloud password.

    Use: IDCProdfirst.lastname  Note: the character just before your name is a BACKward leaning slash.

    5) When or if you see a box pop-up (even if emerges behind your browser) asking if you want to run a RemoteApp program from  "Prosuite.Allscriptscloud.com", then click on "CONNECT"

    6) Next screen should be the green "Allscripts Professional EHR" login. This is just what you see at the clinic, and it’s where you enter your PERSONAL password.

    Congratulations, you’re in!

 
"Cheat Sheet" for Providers’ use of AllScripts Professional, tuned to step-wise process at Open Door (update 8/20/13)

Online Tutorial Lessons for Providers in AllScripts Pro

(extremely elective, marginally useful)

  1. Download Google Chrome or Mozilla Firefox onto your computer:
  2. Log-in to Allscripts Adoption Accellerator:
  3. Register (using your own name & your own email or preferred login), with your choice of new password.
  4. Urban Ministries’ AllScripts account is 76843
  5. Choose "Provider" and the "primary-care generic / wellness" category to determine your course pack
  6. Log-in using your user ID
  7. Click on green button "Take me to my online learning"
  8. Choose the top tab: "My Learning" to show the long list of lessons
  9. Select a lesson, ie. ”ALL-PEHR-0010 Navigate the Chart”.

I think that the advantage of pre-training will be used up before you reach lesson " ALL-PEHR-0110 Messaging"… but we may be using MUCH more messaging in the new system.

To “disable the pop-up blocker”, or otherwise stated “allow pop-ups”:

a)     In Google Chrome :  Look for an icon with a red x in the browser window, where the URL appears.  Click on that little icon and follow the prompts to allow pop-ups.

b)    In Mozilla Firefox:  A yellow ribbon will appear below the browser window saying that the pop-up window has been blocked.  Click on it and follow the prompts for allowing pup-ups.

Return to the lesson selection screen, select the lesson again.

The lesson pop-up window may appear in a separate window in the background.

Select it by finding the tab for the window on the bottom task-bar of the screen.

Be sure to turn on the sound … all the actual instruction needs audio.