AC has a lot of problems that have never been fixed, so we are using work arounds, and always have been.
Reception: Most EMR's have a check in feature where it changes the color when you check them in, and also starts a timer. It would be really useful to track the time in the lobby, the time in the exam room waiting, and the time with the doctor. We have double all the visits on the schedule, i.e. two Acute Visits, one has an asterisk. This is so the receptionist can change them to a different Acute Visit, a different Wellness Visit, etc on check in. This changes the color and the MA can see they've arrived. We've gone through several iterations with check in. One problem is you can really only have one chart in someone's hands at a time. (Another AC limitation). So we quit passing charts around. Generally in the morning I start my wellness charts, send my orders to my MA, and then save to my box. I am logged into charts in my rooms, with the windows locked on screen saver. The MA opens my box and opens that chart, enters the vitals, and then resaves and locks the screen. Keeping it in the box, saved, allows everyone to access the chart when needed. If you go back to your office and open the chart without refreshing the screen, it will open a NEW chart. This is another AC bug/short coming. You have to be careful to refresh the screen. (This software, despite all the years I've used it, is still very amateurish and unprofessional, IMHO. These bugs have been talked about with dozens of others and never fixed.)
Nursing: Each doctor has his own MA. You send orders to your MA. We use this continually: Labs, Referrals, Imaging, etc all goes to the MA who takes appropriate action. It would be a mess to send to a general NURSING box, but AC has that set up if you want to pool them all. If you order a flu shot, it goes to the billing sheet. I usually finish my notes during or at the end of the day, but I have a small "superbill" and follow up card to give to the patient who takes it to checkout. We have Quest online ordering with their web page, but I wish we could order Quest through the chart system.
Billing: I use an outside billing company. They are local, they are friends, they charge 6% but I do most of the coding.
