Home Forums Discussions Problems Mssing Notes....

I am curious has anyone ever experienced missing notes? I have gone to retrieve a patient record and numerous addendums are missing. Tech support is loaded and has not called back yet. Any suggestions???

I have had the same problem. Support has up-loaded the database and found nothing. The only thing that survives is the ICD-9 codes are in the drop down area for them. We try to catch this before we log out for the day so that some of the note can be retrieved from the deleted files. This have happened multiple times recently.

Hmm, I had been seeing something like that when we started. At first I thought the notes just weren't being signed (since we had just started).

What version of AC are you on?

First I am so sorry for the typos, I was a bit upset and still am. We have upgraded to 4.0.60. I have been using AC since May and this occured in January. This is the first that I know of but havent gone and pulled a great deal of charts to review until now as we are seeing repeat patients. Basically I am missing numeorus addendums and phone messages that were signed and then placed in my supervisors box by AC for co-signing. I am in the process of tech support looking into this but was told today they had never have anyone experience this.

Were you still on 3.7 in January? I had a similar problem with 3.7, I found the trigger, but I couldn't say exactly why it happened.

I don't believe it effects 4.0.60

I had this start really bad after the upgrade to 4.052 the have made several upgrades and IT IS still happening with 4.060. I have had it happen twice this week.

I realize this goes against the paperless office, yet I print up all my notes (or drafts if I haven't signed off yet) at the end of each encounter with a patient so I don't lose what I did in the visit. I started doing this after I lost a few notes in V 3.6 when the database "froze". I have not noticed any problems in v 4.058 yet. (I still continue to print all my signed notes since I am still not completely trusting the computer yet. Even though I love computers, I'm still "old school" in the sense I like a hard copy as well. I feel the extra expense is well worth the security)

NO I had not upgraded in January. What I find the most interesting is how tech support spoke to me about this, she made me feel like an idiot and this had NEVER happened to anyone. I was out of town on Friday and my administrative assistant was out sick so I do not know what they have found. But when I asked to escalate this to someone else she said they could not she had to look into it first at level one even though she had never heard of it. I will keep you posted. I fully intend to speak to someone Monday that can tell me why or what to do. My ? for Monday is can since we backup to AC can they go and pull previous ones and try and retrieve it?

I have also found notes that were missing. I have not updated to the 4.0 version. I am still using 3.7. I think that someone at the front desk may have been updating demographic information during the same time I was typing my note. I have since told my staff to make sure all demographic information is in the chart and saved before they take the patient back.

Could you tell us what your trigger was? I have a similar thing but I haven't seen a definite pattern.
It's quite frustrating.

I wish we had any idea. We can not find a pattern, arent sure how many are missing etc. Tech support looked and could not find any of them. They were addendums by 2 different providers.

First, let me apologize if one of our tech support folks or operators made you feel like an idiot. That is completely unacceptable, and if you know the name of the person, I would very much like to know. We have had a few complaints about one of our operators, and we are working to resolve these.

Next, we have heard intermittently of lost patients/notes. The difficult part for us is that we must replicate, or figure out what the steps are that could allow such a serious error. One thing we have found, after much research with two affected practices, is that the SYNCH utility did have a programming error (bug) that could, in some instances, allow this to happen. Given that this is so serious, once found, we quickly did a new release to beta to resolve this issue - this is V4.0.62b, which is currently on the beta site at www.amazingcharts.com/beta.)

We have not, however, found issues of missing messages or addenda (or heard of this from other practices as yet), and we haven't been able to replicate this issue. Replicating an issue is always required for us to find where in the source code an error is. Staying on top of our tech support if you are not getting a resolution or advice on next steps is important. We do meet regularly to go over all outstanding issues, especially those that have such serious ramifications as missing documented data.

We frequently see user error (e.g., the message or addenda wasn't actually saved) as a source of problems, but that should always be the last conclusion after we've ruled out other modalities for such a problem. That said, Amazing Charts doesn't provide a means to co-sign messages or addenda, only notes, so I'm not sure the process by which you are documenting and forwarding these to get signed off. Please contact support again, and refer them to this thread if need be, and if you feel the issue isn't getting the attention it deserves, please email me directly.

Thank you Jonathon. When I finally asked for Carlos to address the issue we were upgraded fairly quickly and I made him aware of the initial contact with support. I intend to call Monday am for a follow up. The interesting thing on the addenda is that I wrote some as did my husband (supervising MD) and he had pulled the one I had written to read it. Unfortunately we didnt know they were missing until over 2 months from the time of the visit. What we did was in this instance due to the complexity of the patient the chart was forwarded and he wrote a seperate addendum. Thank you again for responding.

I am a brand new user, trying to convince my staff that paperless is the way to go, I pulled a chart for a patient visit 2 weeks ago to check the lab result and there was no note to retrieve. I thought this was because I had exited before signing but now I am not so sure. are any of you still having missing notes? I am using version 4.0.60

Yes, I have lost notes also. I think one of the big problems is that there is no "automatic save" feature. For instance, when I close Quicken, it automatically backs up the program to add any new info. I would realy, really love to see AC have one of two options pop up when I try to close a note. "Save and Forward" or "Sign Off". They are not always synonymous.

Leslie

An pop up to "save and forward" or "sign off" certainly would be a great solution. Surely this couldn't be too hard to program in. I wonder why it hasn't been done that way. To lose data so easily is a very big downside.

we have also lost notes. I did a search of the patients name and we found the html documents with the notes in them, but when you pull up that patients name while in the AC program, nothing is there. This seems to happen when we sink the laptop with the main server after returning from another office. Has anyone else had these problems? This is making it very difficult for us to go paperless.

thanks

Lost 5 notes today,maybe 10 or so since Friday.
After spell check, bug report comes up, then message that AC has had multiple errors and must close. AC closes and upon opening AC, Note is on screen, if attempt to sign note disappears; however, if forewarded to self, shows up in mailbox, can be printed as draft of current note,cant be signed, and doesn't show up as last encounter.

Mario Maurizi,
Office Lackey

Mario,

If I may be so bold as to suggest a few things. I am reading this thread, and I would like to help if possible. This is not to brag, but I have used this program over six years and have never lost a note. Not one. So, I sit here and try to figure out how others are losing notes. First thing, in your case, is I would not do anymore spell checks. I never do them, because the spellchecker just isn't that good.

To everyone: This is just a bizarre thought, but I was wondering if permissions has anything to do with it. While I am usually very careful who has what permission to what, are you give FULL permissions to "Everyone" and "All Users" besides Administrator, Power Users, Owner and System? Just wondering since Read and Write would be all one would need but that would leave Modify and Full. I would go to the Amazing Charts folder, right-click, choose properties, then choose the security tab and make sure you have all of the above in the window, and they all have Full control. Normally, I wouldn't give users full control, but what the hell. And, the Owner doesn't really matter.

Now back to mariom:

What I am reading is "after spell check, bug report comes up, then message that AC has had multiple errors and must closes." I think you can just narrow that down to "after spell check, AC crashes, not to be particular, but we have all gotten used to that screen many times. When you forward the chart to yourself, you can print it, but I am confused as to why you can't open it again, choose not to delete from your inbox given that experience and continue on with the chart.

OK, the thing I started with, but got off track. I am not sure if I can help, but I would have a much better chance if I knew more about your system, e.g.

What computers are your using, Vista Business, XP Pro, XP Home, whatever. Are you running peer-to-peer, Client/Server non domain or Client/Server on a domain. Are you wired or wireless. What router or firewall are you using? Are you using software firewalls on your PCs or Windows Firewall or none. Is every PC using the same speed NIC card and are they autonegotiation? Is the computer that AC is on a standalone computer or is someone else using it? How are you sharing your AC folder. Is this happening on every computer that is typing notes or just one?

This information would be helpful. As far as the NIC information, you would need to right click on My Computer, select Hardware, then Device Manager then look at the properties of your NIC or Ethernet card in that list. Basically, AC is crashing at a certain point, and we need to find out why?

The best way to do this is to isolate things down to the lowest common denominator. If the PC that is acting as a server is being used by someone, in the evening try to reproduce the crash without that person on it. Then try to make it crash from just one computer. Does it only crash during or after spell checks?

Bert:
Wow, you said a mouthful!

First, for clarification, I am not the practitioner here,I am the IT dept. by default, not qualification. Ie. I know enough to be dangerous.

The hardware: peer to peer, all on XP Pro except reception on xp home. ( I just remembered that. could that be a problem, I wonder.)all computers discrete names, same work group, all using windows firewall,Iolo anti-virus, periodic maintenance w/system mechanic pro and registry fix 7 especially immediately after software installs.

"main" is bare bones, gigabyte m. board, core 2 duo 3.1, 2 big hard drives, c drive has 32gig buffer, 2 or 3 gig ram. AC is on c drive, backups on e drive. rarely used for anything but server.

Syncing computer is dell laptop, core 2 duo, 2 gig ram, 250 gig hd.

Acctg. and billing, dells, similar hdw. to laptop.

Older Celeron 1.8 gig at reception runs xp home.

Router is DSL modem Siemens Gigaset se567.

All but syncing computer are hard wired all the time, syncing computer seems to perform the same wired or wireless.

Ac is shared to "anyone using this computer," there are no windows limited user accounts. (tried that but had some functionality problems in some apps.)

Have not yet identified network cards, speeds or autoneg. though I can say they all see the server and the server sees them and we print across the network.

The event: Mary, the NP, my wife, screamed, angered, in shock and awe. I office lackey/husband unfortunately nearby, responded
to the scene with due dispatch and some trepidation; whereupon I found this pillar of competence and determination reduced to babble. (Computers are not her friends, she has no desire to understand more than how to do what she must to get the results she wants.)

After the sound and the fury give way to grudging rationality I extract a rough chronology as follows:

write note. go to sign note. spell check pops up.spell check. go to sign note. bug window appears. report bug. close bug window.next popup reports many errors...AC must close. AC closes.
Reopen AC. note is on screen. go to sign note. note disappears.
go to last encounter, blank except icd-9 codes.search summary, meds. nothing added.

Next day she finds herself a work around:

Same as above except when she reopens, she forwards chart to herself and prints draft of current note.

this was the same experience on the sync computer and on a hard wired network computer.

With superhuman forbearance, she lastly condescended to try one more variation. On the main computer there was no problem, AC performed as expected.

Thanks for the concern and offer of help.
Thanks for listening.

Mario Maurizi
Office Lackey

Mario,

Damn, you better never leave the boards. You're way too funny and clever. And, remember, don't give up. Again, I have yet to lose a note. And, given I said that yesterday and did not lose one today, means volumes.

First, don't fear about XP Home. I am not fond of it, but its only limitation is only five computers can connect directly to it and ten to XP Pro. Now, realize it can NOT connect to a domain.

OK, the first thing I want you to do is this:

Get yourself a nice Diet Coke or whatever your beverage of choice is. Leslie and I drink Heineken but only after lunch (She is another user and one of my favorite, lol)

Go to each computer and open the main screen. Now put down the beverage and push CTRL with your left hand and "U" with your right. On the first tab (default) make sure EVERYTHING is checked and on the second tab make sure EVERYTHING is unchecked. Save changes. Go to next machine. Of course, you can go back and fine tune, but these quick changes will stop ALL pop up error messages that you are allowed to stop AND WILL STOP THE AUTO SPELL CHECK.

Are you using a switch or is everything connected to the DSL Modem? If so, what is the speed of either?

I am still not quite sure when you forward the note and print it, why you don't open it and try to sign it off.

[quote=.}AC is on c drive, backups on e drive. rarely used for anything but server.{/quote]

I am deeply troubled by this and shall not get any sleep until it is either clarified or fixed. I hope you are not backing up all of your wife's work onto the same drive whether it is partitioned or not. At least I hope it is a completely different drive. But, if it is only a partition on the same drive, you must at once move your backups to an external drive or at least another computer.

Hi Bert,

Did the checking and unchecking.then decided to find out for myself why not sign note from mailbox, pulled last chart from mailbox, signed (forged)it( I know her p/w)and got error message. AC closed. reopened.chart still in mail box.signed again,error message again.

JB's angels are working on it, I'm sending them bug reports tonight. Here in AZ we are on Mt. std.time all year, (Don't ask me I'm from PA until 3 yrs ago) so maybe they can figure it out in time to do us some good.

Sleep well, E is not a partition of c, it is a hard drive. Backup is also scheduled daily w/ AC online and weekly on a WD portable hard drive.

Online backup is a little spooky for me, but if its really out there and a crash occurs and I'm unavailable, the angels can get it back up and running.