Lee,
Great job. I am excited for you. I think you will find that even though it does take a lot of time, integrating computers and software with your practice will make it much more productive and fun. Using Sharepoint form SBS and the Internet with Lexi-Comp and eMedicine and UpToDate, etc., I can practically fix the patient in the room right there.
Just a suggestion, but maybe you won't like it. My nurses triage my patients in triage and forward the chart to me. That is not my suggestion, lol. They do all of the subjective stuff and the vitals. Now, they may write, "Johnny presents today with fever. He is taking Tylenol and Dimetapp." But, I don't allow them to actually enter medications. I always do that. I don't think they can fully interpret what the patient is telling them and how to write it. For instance, if the patient says he has heartburn and is taking Zyrtec, they may write in Zyrtec where you would know he or she meant Zantac. Also, one thing I ALWAYS do no matter how far behind I am. After reading the HPI and saying hi to the patient and retaking the HPI/ROS, etc. I always double click on the medication list at the bottom left and go over their medications. Are you still on this or that? How is the Prevacid working. It keeps the medication list tidy as I inactivate those that are not being used or change the dose for those who decide to change doses without telling me. Plus, it reminds me quickly of what they are on.
Get that computer for them as soon as possible. Like tomorrow. At first they may be a bit overwhelmed, but eventually, they will love sending messages through AC and documenting everything. Our rule is basically if you talk to a patient, you better write something. They want an appointment, write it in the scheduler, they want to talk with me, send me a note, you tell them to put A & D ointment on, you write a note to that effect and save it. If a patient tells me my nurse told them to put on sunscreen or I overhear her telling them to take 0.8 mL of Tylenol, I will look every so often to see if it was documented.
As for the DNS, I doubt I can help you there. Sounds like a bug either with AC or DNS. Have you tried the latest version? Or have you tried going back one? Anyway, I emailed Brian Cotner who is the DNS guru to see if he minds if I give you his email address. I can't imagine that he would say no.
