Our office just started out with AC and our doctor depends heavily on aggregating large amounts of information in the most recent encounter section before the patient comes in. Patients are seen for an hour and numerous health issues are discussed.
What we do is, a few days before the patient comes in for their visit, the front desk transfers information from their paper chart into the PMHx, SocHx, Family Hx and Allergies section (since we're not all electronic yet!), we change the date of the encounter to the date of the patient's visit, then we forward the chart to the doctor with "APPT PREP" in the subject line.
The doctor checks her inbox and knows which patients to prepare. She'll make her notes/changes/updates and forwards it back to herself or the front desk when the patient is ready for her appointment. Then the encounter is signed when the patient is actually in the office.
In a way, this method does "tie up the charts"; but we've found that you can make changes to the demographics, summary sheet and can even attach a message to the chart and it all gets saved regardless of whose inbox the chart is in.
The only thing we haven't quite worked out is if a patient cancels her appointment. Do we forward it forever or sign it with something like "CANELLED APPT" in the Chief Complaint so it shows up as the subject in the Past Encounters section?
So far, this has worked well for us. We've developed a standardized subject system to name forwarded charts or messages so that when you click the "Subject" header in your message box, it orders everything alphabetically by subject (that way all the "APPT PREP" charts show up together, etc.) This helps to at least improve the appearance of a cluttered inbox!
Hope that helps!
