Home Forums Discussions Problems Still missing notes

We seem to have charts "go missing" at least a few times each week. There are people that are on the schedule, we remember seeing them, they even have a diagnosis in the summary area for that day and yet the note is just gone..poof.. Anyone else having this problem? Something else I need to be doing? Something I am doing wrong?

In my office this has been occuring quite often as well. I don't know why? It is happening with both providers.

Are you using the sync feature? We had a similar problem in our office. No more sync no more lost charts. I posted on it earlier.

We are using it in my office. I don't know if the lost notes are the ones subjected to sync or not?

That was our problem, if my partner stayed and worked on charts after I would sync to go home we were missing charts. We did not realize this was happening until one day it happened in reverse. We just though she was screwing up the computers again- a recurring joke in the office. One evening I stayed late, did several charts, and the next day they were gone. I realized that when she did the sync and left then returned the next morning that she wiped out my charts. We now use log me in (free)on suggestion of Bert. We have not lost any charts since doing this change. We keep a list of the charts we see until the next morning and then just pull up the names to make sure the charts are still there. The lost charts must have something to do with the way the system transfers the data base and then backs up. I am by no means a computer guru but I know this was our problem. Stop using sync and see if this helps. Please post your outcomes and hopefully tech support can fix this in an update.

I may be wrong. I once spent hours and hours experimenting with sync. This was back in 3.0. I think sync is tolerable if you are a solo practitioner. But, if it is truly SYNCING, then after the sync your Main computer will have the same data as your laptop. So, let's call it Main Computer, Laptop A and Laptop B.

Dr. Laptop A goes home and does five charts. She comes back and syncs her computer with the Main computer. Now those five progress notes would be on the Main Computer and everything on the Main Computer would be on Laptop A. Then Laptop B syncs, but is missing the five progress notes that were on Laptop A. Now if the Main Computer TRULY syncs, it would possibly see the fact that those progress notes are not there and delete them. Now, of course, it could add them. It just depends on how it is set up. The following examples from Microsoft's free Synctoy 2.1 may help. These are not to be read after drinking. And, that is after they simplified things. But, Synctoy talks about Left to Right, because it sets things up by browsing to a folder which it calls the left folder and then browsing to a folder which is the target folder and calls it the right folder. Then it has different methods for moving files from left to right. Or in our case from the laptop to the Main Computer. So:

SYNCHRONIZE:

The synchronize action will make two folders mirror each other, keeping the latest changes made to the files in either folder. New and updated files are copied both ways. Renames and deletes on either side are repeated on the other. Folder Creates, folder deletes and folder updates are also propagated both ways.

For example, you have two computers. You keep a copy of pictures, documents, and/or tunes on both. Changes often occur on both computers. You want SyncToy to notice additions, deletions, changes, and renames on both computers, and then do the right thing to bring the folders back in sync. Synchronize is the SyncToy action to use.
Every file in the left folder that is new or changed is copied to the right folder.
Every file in the left folder that has been renamed is renamed in the right folder.
Every file that was deleted from the left folder is deleted in the right folder.

Note: SyncToy does not actually delete any files by default. It merely moves the files to the Recycle Bin. To change this behavior, uncheck the "Save overwritten files in the Recycle Bin" option in the folder pair option window.
The process is repeated for files in the right folder.

(I guess this would be a nice feature, if possible)


ECHO:

The echo action will make copies of files that are new and changed on the left to the right. New and updated files are copied left to right. Renames and deletes on the left are repeated on the right. Folder creates, folder deletes and folder updates on the left are repeated on the right.

For example, when you travel, you take a copy of your pictures, tunes, and documents to work on. When you return, you want SyncToy to notice the files you added, changed, deleted, and renamed in the left folder, and you want SyncToy to recreate those additions, changes, deletions, and renames in the right folder. Echo is very similar to Synchronize, except Echo works only left to right.

Echo is the SyncToy action to use.

Every file in the left folder that is new or changed is copied to the right folder.
Every file in the left folder that has been renamed is renamed in the right folder.
Every file that was deleted from the left folder is deleted in the right folder.
No left folder files are deleted, or renamed.
No files are copied from right to left.
Right folder files are deleted


CONTRIBUTE:

Contribute will add changes from the left folder to the right folder. New and updated files are copied left to right. Renames on the left are repeated on the right. No deletions. Folder creates and folder updates on the left are repeated on the right

For example, you have a compact flash, SD, USB thumb drive, or other removable media that you take with you when you travel. You probably delete some files on the removable drive while you are away so that you can add or change other files. When you get back, you only want SyncToy to recognize new, renamed, and changed files, and you want the new stuff copied to the right folder. Contribute is the same as Echo but without the deletes.


Contribute is the SyncToy action to use.

New and updated files from the left folder are copied to the right folder.
Files renamed in the left folder are renamed in the right folder.
No files are deleted.
No files are copied from right to left.

Reading through these, and I would suggest just for fun that you download it (just Google Synctoy) and read these where they are formatted better and there are charts, which are even more confusing.

But, if you always think of the left folder in Synctoy as the Laptop and the right folder as the Main Computer, then I would especially look at the deletes. Echo seems to make sense even with the deletes. Contribute seems the best, although I am not sure what is supposed to happen if you delete a medication. Should that be recognized?

But, the nice thing about looking at these is that they give examples of taking a USB or other portable drive (laptop) away and how they would sync back.

I, again, have no idea, but if Laptop A comes back and syncs five new progress notes and then Laptop B comes back, wouldn't the Main Computer see Laptop B, (and given that those notes aren't there), look at it like they were deleted? And, therefore, delete them from the Main Computer?

CAVEAT: I am not suggesting using Synctoy in place of AC's built in sync program just using it as an example of how syncing can be done differently and affect the outcome differently.

Whether I am right or wrong or contributing anything to this discussion (and I am certainly not knocking the program), your data is mission critical. Therefore, no matter what, I would use a VM or a standalone sandbox machine and play with it multiple, multiple times with a fake patient base to see how it works for you before you run out to the nursing home.

I hope that in the future they will change it to always be cumulative and never cause a deletion.

When I first started using AC a visit note would sometimes disappear. It happened in a very erratic and unpredictable pattern, we would also have messages delivered to the recipients deleted box instead of the in box. Comments on imported items would get lost, and probably some other things that I don't remember. Tech support looked into it and our IT guy reconfigured the network ( I don't use any SYNC stuff). Now I don't seem to be losing anything ( been using AC since 4-2009). Some of it was probably user error, but not all of it. Bert gave me the advice to just "wait it out" and it would probably go away. At the time that frustrated me, but turned out to be what happened.

yes, I believe that it would be best to somehow be able to always append or have a cumulative backup and sync as opposed to only the standard sync function. Maybe when AC is being set up, there should be a warning message that pops up after 2 or more physicians are inputted into AC as users, stating that the sync function is best used with one practitioner. Also, it can mention that once a laptop is synced and re-synced to the database the next day, ALL data added between those two incidents will be ERASED.
(maybe in addition, AC prevents new data from being inputted into the computer that will be erased regardless? Of course this would not be user friendly but its better than doing all of that charting and then loosing your work!)
Also, AC may benefit from noticing that new information has been inputted to AC after a sync, and when the new laptop comes in to sync, AC can only backup the newly added data, then sync the laptop, then append the new data to the main database (and then backup everything at that moment to make sure its all one file in a safe place!).

Also, maybe there can be an option to disable sync (in a 2 doc or more practice) in the administration menu if the administrator knows that the docs will screw things up and doesnt want to deal with the possibility of losing files.

In all, I think the first option I mentioned would be great (laptop syncs, new data is inputted on main computer, laptop returns from home visit, syncs to main computer, AC recognizes new data inputted since sync to laptop, AC backs up newly added info from main computer, then updates main database with what laptop has, then AC appends newly added info from between syncs to main database, and then finally, backs up main file).
Maybe an easier way would be to do the opposite and allow the main computer to still act as the main database and treat the laptop as new data appended to main database (never to overwrite main computer database). This seems better since more work will be completed on the main computer and if a doc had to loose one database over the other, they would probably loose the data on the laptop rather than what was inputted in the main computer database.

Just my two cents...

Last week, I wrote down all the machinations of how sync would work with two laptops and a main pc. It seemed to make sense. I wrote it all out on here, but then the browser crashed. I have to tell you, just the thinking it through drove me crazy.

But, it can work. I just think you actually have to "practice" like anything else.