Dovetale Information

OBTAINING REMOTE ACCESS TO DOVETALE

During this rotation, there may be an opportunity to complete charting on your own device - either at the hospital, or from your own home. This has been helpful during the pandemic at times when working remotely has been encouraged. To do so, you will need to obtain remote access to our EMR (Dovetale) via the Citrix Platform.

• Instructions regarding how to obtain remote access are contained HERE.

• We typically need to complete a "Request for Service or Access" form on your behalf to make it possible for you to obtain remote access. We try to have this done prior to the start of your rotation. Please advise us if you are unable to complete the process.  

• You may be able to set this up yourself, using the following link:

  • Remote Access Application 

• You will eventually need to set up "2-factor authentication" using your phone; please see the instructions above (under "HERE") for further instructions. 

• If you have any issues logging in (or forget your Dovetale ID), you may need to contact the IT Office (2nd floor Juravinski Innovation Tower, beside the library) to sort it out. Their number is 905-522-1115 x 33040.

DOVETALE DOCUMENTATION DETAILS:

Please review the following information regarding how our team documents consultations within the new Dovetale EMR.

1. Intake and assignment of consults:

   1. One Case Manager (CM - Pat, Leanne, or Shari) is responsible for screening the team list each morning to find new names. 

   2. The CM assigns each new patient to the Attending through Dovetale.

   3. After the morning team meeting, CM assigns each new patient to a resident through Dovetale.

2. Documentation:

• 1. The Resident (or Attending Physician initiates) the consultation note. 

  2. Label as a "Consult" note only once; all later follow-ups notes for that patient are labelled as "Progress" notes.

  3. Label all notes as "Geriatrics".

  4. Use the template (in shared smart phrases) as directed by the Attending Geriatrician. 

  5. See details below regarding who completes each section.

3. Incorporating Case Manager Sections:

• 1. Case Managers will complete a separate progress note that includes the sections of information that they have gathered. 

  2. Please cut and paste (or, alternatively, summarize) these sections of information into your consultation note. 

4. Once your note sections are completed:

• 1. Check off “Gerontology consult” in the details section.

  2. Ensure that “cosign required” is checked off.

  3. Assign "cosign" capability to the Attending Geriatrician. (This process will become more apparent as soon as you have completed a consult.)

  4. Finally, sign the note.

5. For this initial consult note, all team members are responsible for generating clear, grammatically correct text of sufficient quality for a consultant letter. Please consider using the spellcheck button before co-signing your notes. 

6. Setting up your dashboard: At the beginning of the rotation you should personalize your screen. Review this with a team member if unsure how to do this.

• 1. Add I/O flowsheet (where you can find bladder and bowel function)

  2. Add Cares/Safety flowsheet (where you can find info on nutrition and sleep)

  3. Responsive behaviour flowsheet

  4. Geriatrics handover column in your patient list

  5. Create a smart text with your signature and contact info to add to end of your notes

7. Other Information:

• 1. Check that PCP is on file – otherwise no notes will get there

  2. Residents needs to log in under Geriatrics Services (not IM, Obstetrics, etc.)

  3. Sticky note or handover function can be used to to keep track of pertinent details

  4. Link to access Dovetale through Citrix https://remote.stjoes.ca/vpn/index.html

Example of a Consultation Note (and who is responsible for each section):

Geriatric Medicine Consult

 Thank you for asking us to see this @AGE@ year old @SEX@ regarding ***. 

 Prior to admission @HE@ was living at ***. Collateral history was obtained from ***

PAST MEDICAL HISTORY: 

@PMHP@ 

Resident completes/clarifies this section (please add details as appropriate)

PAST GERIATRIC/PSYCHIATRIC HISTORY: 

Case manager completes this section

MEDICATIONS: 

Resident completes this section

PRN Medications & Usage:

Resident completes this section. Please indicate recent frequency and dosage of PRN medications, especially opioids and psychotropic medications. 

Allergies: @ALGP@

HISTORY OF PRESENTING ILLNESS: 

Resident completes this section

Course in Hospital: 

Resident completes this section (please review relevant notes from the care team, including interdisciplinary professionals, in Dovetale)

Cognitive History: 

Case manager completes this section

Family Concerns: 

Case manager completes this section

 FUNCTIONAL HISTORY: 

Case manager completes this section

 Basic Activities of Daily Living (BADLs)

Bathing-

Dressing-

Hygiene-

Feeding-

Toiletting-

 Instrumental Activities of Daily Living (IADLs)

Cooking-

Laundry-

Cleaning-

Shopping-

Maintenance-

Finances-

Medication-

Driving-

 SOCIAL HISTORY: 

Case manager completes this section

POA-

Birth Place-

Year moved to Canada-

Education-

Employment-

Current Interests-

Marital Status-

Number of Children-

Living Situation-

Smoking Hx-

ETOH Use-

REVIEW OF SYSTEMS: 

Case manager completes this section

Hearing: 

Vision: 

Nutrition:

Sleep:

Pain:

Bladder/bowel: 

Current mobility:

PHYSICAL EXAMINATION

@GERIATRICCONSULTVITALS@

Resident completes this section, including neurological examination, as appropriate. (Please do not attempt post-operative gait assessment in Orthopedics patients)

Prior Cognitive testing: 

Case manager completes this section

INVESTIGATIONS: 

Resident completes this section

 IMPRESSION & PLAN: 

Resident completes this section, using an issues-based approach. Please prioritize the "RFR" first.

Resident: @ME@ (Please include your contact information)

Geriatrician:

Case Manager:

Contact information for Dovetale Training Sessions**:

Dovetrain@stjoes.ca

**It is essential for every learner to have completed his/her Dovetale training session prior to (or at the very beginning of) this rotation. Otherwise you will not be able to access the Electronic Medical Record (EMR) at our hospital, and consequently will be unable participate in patient care. 

Your home program coordinates the timing of these training sessions directly with the Dovetale team. Please contact your Program Administrator if you are unaware of when your session is to take place. Typically, they occur from 0800-1200h on the first day (Tuesday) of the rotation block. During COVID restrictions, these sessions have been offered virtually, via Zoom.

(If you have been trained on Dovetale for a prior rotation during residency, your account is still active and another session is NOT required. If you are unable to login on the first day, you may need to visit the IT Office to have your account re-activated.)

The IT Office is now located on the 2nd floor of the Juravinksi Tower, beside the library. (This is the location previously occupied by the parking office.)