Vestibular & Concussion EMR

How vestibular/concussion sessions flow in PBS EMR

• Prep: safety line first (central signs, falls risk, cervical red flags), meds/migraine context, stage of recovery, suspected canal, and prior outcomes.
• Session: oculomotor screen/VOMS → positional testing (Dix‑Hallpike, roll) → canalith maneuvers → VOR x1/x2 adaptation & gaze stability → habituation → balance (mCTSIB), gait (DGI/FGA), dual‑task/return‑to‑learn/play → wrap‑up/HEP.
• Note: AI drafts SOAP with citations and symptom thresholds; inclusion cues and stop criteria keep progression safe. Plan/HEP update automatically.

Outcomes tied to what you did

Track DHI, ABC, VOMS domains, mCTSIB, DGI/FGA, DVA (lines lost), VOR speed targets, symptom scales (PCSS), and BCTT heart‑rate thresholds for graded exertion. Measures link to interventions so progress and plateaus are obvious and defensible.

BPPV & canalith maneuvers

Document canal/cupulolithiasis, maneuvers performed (Epley, Semont, Gufoni, BBQ roll) with nystagmus notes, response, and post‑maneuver precautions. Templates keep contraindications and cervical considerations in view.

Concussion: graded return‑to‑play/learn

Stage‑based templates with symptom ceilings, rest periods, HR caps from BCTT, visual/vestibular load, and school/work accommodations. Clear pass/fail criteria make next steps auditable and easy to communicate to families, coaches, and employers.

Delegation & compliance

Tech/PTA‑ready blocks specify duration, speed (deg/s), target surfaces, dual‑task layers, and stop criteria (e.g., symptom rise >2 points or loss of balance). Audit‑aware phrasing keeps documentation payer‑friendly without slowing care.

Practice management that speeds cash

• Scheduling: long eval slots, maneuver follow‑ups, and staged exertion tests.
• Eligibility & authorizations: verify benefits, track visit limits and expirations.
• Billing: claim scrubber and direct‑to‑payer routing where supported, with ERA auto‑posting for fast reconciliation.
• Payments: accurate patient responsibility, statements, and secure links.

Education only; protocols and payer rules vary. Follow current orders, clinic policy, and safety guidelines.