@AKbeth, we feel your pain!! We have been gradually using more and more of AC for the past 4 months and we are at our wits end!
We have hired new staff to handle the extra work (which, unfortunately, has put a real strain on our finances such that we can't finish buying the equipment we need - but that's another story). We are in this awkward phase of half-paper half-AC which is driving everyone crazy, especially the doctor. She is trying to document things in the paper chart AND in AC, which invariably results in lost information...
It is so good to hear that other offices are struggling with this.
@DocMartin - it is also good to hear that there is a light at the end of the tunnel!
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@elipra - Now to answer your question on how our office stared (and we are not complete yet with our process).
1) First I moved patient data we had in Quickbooks to AC. This helped us to at least get all of the names, addresses and phone numbers in. AC did require birth-dates, though, so we just made up 1/1/1900, and we've been updating them as we go. (Let's just say we still have a ton of 110 year old patients, but it's getting better!)
2) Next, we started with the Scheduler. The doctor still likes to have a printed copy to see in front of her face, but now the staff has gotten used to using it and looking at it (it takes some time to adjust to the sight of it). This helped us to quickly realize the benefits (no double booking! no searching through pages and pages to see if a patient has an upcoming appointment, etc.)
3) We were using a transcription service for the Doctor's notes. This was taking up a lot of time and money so the next thing we decided to do was just write the patient notes in AC (HPI, physical exam, assessment and plan).
4) Before we did this, we had front desk staff input PMHx, FamHx, SocHx and allergies into the note before the patient was seen by the doctor (we try not to get too ahead of ourselves because we forward the charts to do this without saving the note until the patient completes the encounter - we don't want a ton of forwarded charts floating around).
5) Then we gradually started to add Medications and Orders to the list
6) Finally we are in the process of documenting progress notes via the message system (but we are first working on a system to categorize these messages for easy browsing by the doctor)
7) The only other issue we haven't resolved or come to a decision upon how to do is flow-sheet tracking of labs. We will likely implement an excel spreadsheet for this, but we haven't figured out how we're going to do the labs (electronically by interface, or pdf by fax).
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The next step is to do new patients in AC only, but our doctor is a bit frightened by this concept at the moment. She has really struggled up to this point and is not ready to give up the comfort of paper!
Anyway, I hope that helps. Baby steps is the way to go for people who are computer-phobic. However, this does create extra stress during the awkward transition period of using both paper and electronic charts! I am glad to know we are not the only ones struggling with this... we hope to get some insight at the ACUC conference in June. Hope to see some others there!
- S.K.
