Thank you DoctorWAW, Indy & Bert for your suggestions.
Let me update you and answer some of your questions. After spending another couple of hours on the phone with tech support, we made some progress.
We confirmed that there were indeed pdf's in (some of) the import folders.
We scanned a dummy document into a test file. Viewed it in AC and in the test patient's importitems folder. The PDF was still there the next day.
The tech support (TS) guy had previously helped me relax all restrictions in Kaspersky (anti-virus/firewall). However, when we looked at Kaspersky's logs we saw that Kaspersky was not allowing one AC file to run: xadb8.ocx. No idea what that file does. We gave it permission to run.
Lots of missing data. On 7/8/10 I ran the "Imported Items: Repair Missing Files & Links" utility, found under Administrator's Options, Tools. It gave me two and a half pages of missing PDFs, associated by patient ID and telling us the subject of our missing scanned data. The report in and of itself is very helpful, since it helps us identify what was lost. I was puzzled, however, by the report's name "Repair". Files and links were eliminated--which is not how I conceptualize repair. I think of it as re-establishing linkages, restoring files, etc. This utility also helped to eliminate the error messages that took us 5-7 clicks to get out of when trying to view the imported files in AC that were there, yet weren't there. So, we now have many patient ID's with empty import folders.
Now, here's the kicker: When examining some of the patient files for the imported files, we discovered that some files had somehow overlayed other files. So, for example, let's say that in the import items folder there are four files. PDF1, PDF2, PDF3, & PDF4. When we look at the the patient's record in AC, we see six items. There's PDF1, whose subject corresponds to what we see in PDF1. However, in AC there appears two PDF files, each labled something else (say Prescriptions with a date, and Colonoscopy report with a date), but instead of two different PDF's PDF2 & PDF3, the Colonoscopy report and Prescriptions both show PDF2, which is the Prescriptions. The Colonoscopy report is nowhere to be found. PDF3 may correctly represent itself, but PDF4 may be duplicated in AC. It may appear as a Referral from a particular doctor. PDF4 shows up named Referral. The items were scanned in once. How they got mixed up is unknown. The tech support guy says he's never seen anything like it.
The implications, however, are clear: we'll only find out, by careful examination, whether the documents we expect to see actually correspond to the headings in AC. We don't know how many patient records are affected. And we don't know what caused it to happen. And, we, therefore, don't know how to prevent it from happening again.
The TS checked the folder permissions, etc. which seemed to check out OK. The scanner is off the network (to eliminate one set of potential problems--which did't seem to be the issue anyway) and is directly connected to the main computer. We are using the twain driver which came with the Brother MFC (which does not seem to be the issue). Kaspersky is set to let every AC program, file, etc. do its thing.
The only thing the TS guy had to say was to see if we could change the numbering scheme that the scanner software uses. The same name 00000001.pdf is repeated in every patient's import folder. It will then increment the number to 00000002.pdf if it finds a x1.pdf (x standing for the 7 leading 0's). Most scanners, he said, give every document scanned a unique number. Perhaps, he suggested, the new pdf is not always upped from x1.pdf to x2.pdf and therefore x1.pdf is overwriting an existing x1.pdf. Possible? Maybe. But why so randomly? And it doesn't really account for files duplicated under different subject names in AC.
He suggested that I look into the scanner documentation to find a way to have each document given a unique number. I've looked, but I haven't found any such option. I suspect it will need a switch thrown in the registry--which I know enough about not to fool around with. If I persue this line of attack, it means another call to tech support and another few hours on the phone.
I hope that gives you a more complete picture of the problem. I know that this may be a bit difficult to follow, but I'm hoping that one of you (or other forum members) has come across some of these scanning, data base pointers/linkages, etc. issues that can offer us some insights that will give us a better handle on how to deal with these problems.
Thanks.
Mory (on behalf of Dr. Pearl)
