Mike,
When I was setting up AC, it did come as a surprise to me that the user name was used in documentation. I would have assumed it was "private". It would be nice if AC did provide information on set up that the user name would appear in the medical record, since there is no going back once it is set.
Or, AC could just use the formal names as set in each user account in the record, as Mike says.
This is where having instructions or a manual, especially for new users, would be very helpful. The lack of documentation is definitely a negative for AC. It has taken me an extraordinarily long time to learn AC. Most of what I have learned is from the user board.