All physicians in California are legally required to report any disorder "characterized by a lapse in consciousness" to the Department of Public Health, who in turn notify the Department of Motor Vehicles. The goal is to make sure that people with seizures, cardiogenic syncope, etc. are treated appropriately before they resume driving. Whether mandatory reporting really reduces patient morbidity is an area of active debate in the neurology community. However, the law is clear - physicians' failure to report these diagnoses in a timely fashion may lead to significant liability, should the patient continue to drive and suffer another loss of consciousness.

At present, physicians and staff must locate the Confidential Morbidity Report form (http://sfcdcp.org/document.html?id=322), print it, fill it out by hand, scan it into APEX (for medical documentation purposes), and then FAX it to the DPH. This system can break down at any point in the chain, leaving many patients unreported. It is also quite inefficient and resource-intensive.

We propose that the CMR PDF form be available through APEX - perhaps through a "CMR" tab in the visit navigator, available to all physicians in all clinical contexts/environments. If it is possible to autopopulate the patient's demographic information, autopopulate UCSF "reporting facility" information (with the address and phone number changing in response to the clinical context used for login) and route the form to be FAXed via APEX, we would conserve a variety of resources: physician time, staff time, and the ink, paper, and electricity required for printing and scanning. Most importantly, compliance with state law would improve, better protecting our physicians and patients.

- Manu Hegde and Ellen Weber