I am an oddball on this topic (and many others
)
Also, I have never made the transition to paperless.
I have chronic tendinitis in my wrists and can't type long. I also have thick old charts and patients with multi-system disease states.
So, I dictate everything with Dragon NaturallySpeaking.
When my patients come in, I have the nurse enter chief complaint and vitals. She then prints today's note as a draft (Ctrl-D) and clips it to the front of the paper chart. I use that page as a "scratch" sheet to take notes, and dictate from.
The first time I see them with Amazing Charts, they fill out a health questionnaire, even if they are established. I use that and then scan the old chart, if they have one, for pertinent other tidbits they may have omitted.
When they come back for a return visit, the nurse uses Ctrl-N for a new note, and again fills in the CC and the vitals, and prints a draft. *Now* it has their Past Medical Family and Social History, that was entered at the last visit. This makes a very nice reference while I'm taking notes.
The idea was to use this method until enough patients got into Amazing Charts and I could drop the paper chart, but the other problem was I had no room in my exam rooms for a PC and could never figure out how to do it (laptop, slate didn't work out).
