Home Forums Discussions Feedback and Recommendations PLEASE FIX Letters, printing notes

Please fix: 1. When printing the note from the "Print encounters/send letter" pop up window the letter format puts the signiture too far down the page causing the note to be longer than necessary and most often to unnecessarily print two pages, the second page being blank except for the signature. The note format that is in the "Print daily batch" is much better.

2. When composing a letter from the "Print encounters/send letter" pop up window: a. The return address, date, and letter address do not line up correctly to fit a two window envelope. b. The return address does not automatically align at the left margin of the page when that option is chosen. The alternative option must be chosen first and then the "left alignment" option chosen again in order to get it to align correctly. c. The date prints aligned at the right margin of the page rather than at the left margin.

Please, please fix these issues as they require time-consuming tweaking multiple times each day.

I would like some suggestions about using the letter writer... the option to create a letter to the referring provider opens up after the chart has been signed and does not allow me to open the demographic page to see who the referring provider is. I have to X out of the letter writer, type in the patients name, right click on demographics to find out who is the PCP, go back to the letter writer and search the drop down box to select the referring Doc/PCP. I would like to be able to select referring provider from the letter writer and have it pulled automatically from the referring provider box on the demographics page. Does anybody have some shortcuts?

I suggest that AC move away from their own Letter Writer, with the limited format options and quirky Address Book, and instead allow patient data to be exported to Word (or even better OpenOffice) so we can do corrections, formatting, etc.

dklehmannmd,

Hi dk, If you could post your real name, it would be nice so we could address you that way. Or better yet, use it as a signature. It sounds like you are a consultant, so I don't use the letter writer the same way as you. Can you clarify having to go to demographics? I mean how do you find the PCP from there for each patient you are consulting on?

John,

My sentiments exactly. But, it would be easier to just let the letter open in whatever editor you wished. Obviously, Word documents open in Word, but if I uninstall Word, it will look for another application such as Word Pad. You can also choose with "Open With." For instance, in my application, VIPER, the print function opens in Word. But, it would open in Open Office or Notepad, if you wanted.

The letter writer has always been the weakest part of AC and having it saved in HTML is not helpful.

I agree that saving in HTML is not at all helpful.
I wish we could elect to save as whatever word processing file we wanted.

Yes, I am a consultant sometimes. ( Gyn)

The demographics page that I am referring to is the tab at the top left when you are in a patient's chart...where the phone numbers etc are. The referring provider is at the bottom right hand corner. In my old paper charts on the worksheet for the visit the Referring Provider would be at the top of the page and made it easy to remember who to send the note to.
In AC when the visit is finished and you sign the note the process cannot be suspended to look up who referred the patient before the letter writer opens up. I just wish it would "auto-fill", not such a terrible problem but.... I wish.
I am such a newbie to computers that I don't know lots of stuff that everybody else seems to get without any trouble. For instance, Dr. Lauer has a signature block ( see above) I don't know how he did that. My " Add Signature " box is checked, but I guess I don't know how the block is created. Maybe by the time I am 90 or 100.

Deborah Lehmann MD
Fort Worth Texas ( Boy! has it been HOT down here lately!!)

So, did you write in "Fort Worth Texas, etc.?"

Hi Deborah,

If you would like an auto-signature, just type it here or PM me, and I will do it for you. Otherwise, I can simply tell you how to do it or both.

I may have a work around for you, although I am a bit confused. Please excuse me or forgive me if I am misunderstanding. But, wouldn't it be fairly easy to remember who the referral doctor was? Or to write it down. And, my referral list is at the top right. But, do you ever get another doctor referring that same patient to you.

Anyway, here is a workaround that may help. Especially if you don't send the progress note but just send the letter but either way.

In the CC Write: Consultation for Dr. John Smith.

Then when you save the note under Encounters for Bill Gates or whomever, there will be a list in chronological order of the notes. The top one will be the one you just signed off, and it will have the name of the referring doctor in the CC. And, after all, for you it would be the chief complaint. At that point, you could send your letter without leaving the window.

hth

Bert,

Thankyou, I figured out the signature.

That's an idea, to put the name of the referring doctor in the chief complaint I will try it for awhile and see how it looks. Probably work fine.

Bert,

Thankyou, I figured out the signature.

That's an idea, to put the name of the referring doctor in the chief complaint I will try it for awhile and see how it looks. Probably work fine.

Your signature looks great!

Hi Deborah,

I was fooling around and noticed someting pretty cool by accident. It doesn't really make it any easier, but when I was working on a workaround for you, I had put in the CC: Consult for Dr. Smith. Of course, it will be right there at the top of the window on the left, but if you do click on Compose Letter, at the bottom it will say, "Consult letter for Dr. Smith." And, you can delete and go back. Of course, it doesn't really save you anytime. But, it does give you two good pieces of information:

Anything you write in the CC field will show up at least momentarily on the bottom of the letter writer which may or may not be useful. And, I suppose it serves as a confirmation to make sure it is the right doctor you are sending the letter to, although I don't find that very helpful.

Good luck.

AC needs to keep the letter writer, but it should save in something other than html. Even rich text format would be better than that.

Bert,
I think that is helpful, it saves having to go all the way back to the demographics page.
Many of the patients come for a problem (without being referred)but they do have an established primary doc. In the past I would always send a copy of the visit to the PCP to keep them in the loop. I find myself skipping this much more often using AC. I could assign a staff to go back through the days visit's, copy the note and send it, but I have been trying to decrease their list of daily tasks ( decreased staff time = decreased salary dollars).
Now, not being argumentative...If we put the name of the primary doc in the CC it would work but is a duplication of an entry already made to the demographics page during intake....ie not efficient.
How do I add auto fill from demographics to the letter writer to the wish list? That will be pretty far down on the priority list I guess.

But, I don't see a lot of good in saving a poorly formatted letter into Word and then editing it. Why do we need the letter writer window, when it could just open directly to Word? I guess the difficult part would be the having it link to the Imported items. Maybe you could have the preference and save it somewhere else or save it and import it.

One thing is for sure, it is the weakest part of the program by far. Even the formatting of the note could be much better.

Wish lists don't seem to help much around here maybe because Jon's vision doesn't always include ours. But, it's fun to debate them and add to them.

I think I may have answered my own question, because at first I didn't understand if you put James Smith, M.D. down in the demographics how you could be sure he was the referring provider next time. But, I think you mean the receptionist would once again look at her demographics and change the referring provider at that time if a different provider referred her or she had changed providers. Is this correct?

Ok, based on what I am surmising above, I think I have your answer. And, the irony is, it was there all along using the referring doctor.

So, you have your rolodex with all of your referring doctors. Of course, if he or she isn't there, you add them on the day of referral or just type him or her in.

So, the name is chosen and the save information button is selected. Now, the name of the referring doctor is in the demographics.

When you get to the place where you wish to send the letter, simply click on Compose Letter, Print/Fax, then select No at the window where it asks you if you wish to save the note which will leave you with a blank letter on the top left of your desktop. Closing this top page will reveal the next page, the patient demographics including the name of the referring doctor.

Closing the demographics page, brings you back to the Compose Letter. This is where it is nice if you instruct your staff to always put the referring provider with information in the Rolodex so when you get to this point, you can select it.

It is four extra clicks, certainly not perfect, but better than the alternative.

Hope this helps.

just caught back up on this thread. I'm a little confused, but I did catch on to inputting the name of the referring doc in the rolodex. Yes, that will let their name and address show up in the letter writer. Can the referring doc sec in the demographics be linked to the rolodex? Can that help in some way as a future improvement?

Bert, my thing with the letter writer saving into Word is that Ican live with the general formatting of the letter writer. I agree it could look alot nicer, but it works for a "quick" method to shoot out a letter. I have seen alot worse come from other offices. My complaint is that, if I mistype a word or decide I don't like a sentence after I have printed it out, I cannot go back, make a change, and reprint. Because of the stupid HTML saving format. I have to do the whole darn thing over from scratch. I'd like to edit the doc, and reprint it with it looking just as "good" as it did originally. Or how about if I say look the "same" as it did originally? So we dont debate if it looked "good" in the first place.

The inability to change the letter once you get to the print page is one of the reasons I have been sending fewer letters. I don't want to send out something that looks bad, its late and I'm tired and I don't want to start all over from scratch. I am going to have to train myself to do a better job of proofreading. The idea about looking at the demographics page from within the letter writer is excellent, I will use it.

We update the demographics regularly including the primary physician which, I have noticed, the younger patients change more frequently than the older patients.

@ Wayne

and general comments: First, it is strange that the demographics page is different depending on how you get to it. If you right click on a patient in patient list vs open chart and select demographics, things are different including where the referring provider is. Also, typing them in directly causes your keyboard to be taken over by a ghost as strange things occur at least for me. I can type Smith, John but it types SmITH, JOHN or all caps anyway.

My suggestion would be for the secretary to ALWAYS put the referring doctor's name in the rolodex first, then populate the referring doctor's name in the field using the drop down box. Wayne, the original question is can you see the referring doctor BEFORE you type the letter or choose the name in the letter writer so that the doctor's name and address shows up in the letter. I have documented that in detail so I won't here.

As for saving to Word, I haven't worked with too many programs which allow one to do that. I say open in Word, which is possible and much easier. The letter writer should be destroyed and start over. It is horrible. And, one should be able to click print and still have the letter there.

OK, I found a pretty cool way to fix all of these problems. It's a slight workaround so it isn't perfect, but it does help with two things.

First, it depends what version of Word you have. 2003 or 2007. With 2007, the ribbon thing is kind of annoying so I bought this VERY cool add-in that allows you to customize it just the way you want it. So, I put spell-check, select-all and copy all in one heading on the top left. So, I open the letter writer, but then I open the Word on the desktop which has my letterhead and the date and complimentary closing already filled in. This is all optional.

I then type the body of the letter that I would have typed in the letter writer. When done, I click spell check, select all, and copy. I then click CTRL - V, and it is in the note writer, nicely formatted and spell checked, etc. I only copy the body of the letter. I then print it, and it saves to the chart for legal purposes and a reference. But, now you have the copy in Word, which you can now save with the Save As button and save anywhere on your server such as in a folder called Patient Letters. Now, the template is ready for the next patient. If you need to redo the letter, it is right there on your server.

Hey, I agree that the current letter writer is pretty bad. Maybe Jon could talk w/ Open Office about integrating its word processor. Heck the program is free for individuals. They wouldnt want too much money, would they? or would they? And yes, just make doc is that.


I hadn't noticed that the demographics page is different based on how you open it. What's up with that? I'll have to play around and see the differences.

We use the referring provider field so little, it at all, that I dont notice those things. Everyone gets listed as consultant.

Yeah, we don't use it either. And, I guess my staff uses the demograpics, but mostly when entering the patient, so they would only see one version.

Actually, seeing it two different ways kind of shocked me. It makes no sense at all.