" . . . I think everyone wants it perfect right out of the box. "

Bert - One of the strengths of this forum is to introduce and exchange new ideas and perhaps optimize them enough that the can be presented or reviewed by the AC developers as well thought out improvments.

It is clear you have developed many work-arounds probably the best possible within the limitations of the program. But also , why not think about how to improve the program and simplify the work flow.

Again, instead of your work-arounds, why not consider the following:

1. Simply allow closure of an encounter without having to lock it, with default *saving* of the encounter data when the encounter is closed, not a default erasure (I agree fully with Ann Marie, encounter data is unique and irreplacable - the program should do everything possible to preserve it).

In addition:

2. Allow access to the non-locked encounter by other staff memebers with the appropriate level of security so they can proofread and/or add to the chart - and allow this access not just by ackwardly fowwarding the chart back and forth but by allowing multiple user access - again use the *advantages* an EMR has to offer, instead of emulating the disadvantages of a paper chart.

3. Allow the provider to electively sigh-off/locking of the chart - not as a protective mechanism to be invoked against inadvertent erasure, but when the provider is ready and truly feels the encounter is comlpete. (perahps a small date stamp appearing in the corner of the chart wold allow a provider to know when the individual encounter has been locked.)

4. Save encounter-generated correspondence in a more versatile form such as a *. DOC form. The current correspondence saving as an HTML provides no versatility - the provider is left wtih a prematuarely locked chart (with typoes and dragon-generated paraphasic errors) and a unalteralbe encounter-generated correspondence which, by virtue of the HTML form is also unalterable and almost unusable

Bert - I appreciate your suggestions for work-arounds - but lets also try to use this forum to generate new ideas, and by virtue of input from other users, optimize those ideas enought to present them to the AC developers.

Bruce Morgenstern, MD (Neurology)
Denver CO