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Hi Gang,

It looks like Julia and I are going to be meeting with Jon in about a week. I'd like to bring some of the ideas that the group would like to see in the next version of Amazing Charts to the meeting, with the idea of getting some of them on Jon's "to do" list.

In the mean time, my main development laptop decided to take a vacation, and will be visiting the scenic Lenovo repair center somewhere in Georgia. After two days of data recovery I have recovered all of my data, but between that and patient care haven't been my usual active self on the boards (in case you were wondering why I've been so quite lately).

Hope you're all well.

V.

I would love a "look" at the basics for the PM module and how it will or won't work and interface, features, window snap-shots and the like. Any idea on a projected release date? I was just about to reconsider breaking down and buying Altapoint, probably without x-link. I sort of like your idea of having the practice manager and billing folks take a second look at everything before it is submitted. We sort of do the same thing here right now. I review all the invoices before they go out to our billing company. So perhaps by having no x-link, it can help maintain that form of good review.

Also, my Rx and letters, provider drop down box, so other staff can help create things in the office for the provider. For that mattter, anything we can do to get rid of the provider bottleneck in an office and make it more paper like in terms of letting tasks float back and forth among staff as needed, and be assigned on a task by task basis would be great, all while tracking the chain of custody would be great.

Is it a Bug or a Feature? Here's one that is driving us nuts. If one starts a message to another person in the office with the patient attached so we all know which patient the message is about and the doc can attach the message later on if she so chooses there is a bug if you decide to drop or delete the message halfway thru the note. AC is not dropping that patient from the attachment area, so.... The next message that same user tries to create on that same machine for another patient, now has BOTH patients attached to that note, both the previous one and the more recent, just started one. And this can just continue to add on and on forever. The only way that we know to avoid this is to either A) finish and send the first note anyway and just let the person receiving it know that it was a "dump" message and to ignore it, or, B) you have no other choice but to log out and log back in again. That certainly does clear the attachment of the chart/patient section properly.

I just sent my provider a note on a patient that she saved to that patient's chart "before" she realized that another patient was attached to that note as well. Now we possibly have this real issue forever in this patient's chart. A fix for the mistakes like this that have already been generated would be nice too. Even if it means a bit of effort on our part to clean up the record.

Here are some observations which will make this overall great EMR masterpiece even better:

1. Full integration with E-PRESCRIBING especifically with eRxnow which is free.
2. Improvements in MEDICATIONS SECTION
2a.Ability to costumize the drop down menus
2b.Some people have suggested Rx insurance info in this section, immidate formulary check or alert would make make it very valuable.
2c. Ability to stablish the # of days for treatment for especific medication and automatically sent it to the inactive medications list.
3. New window for Tracted items with a tab in Main screen. It will make the layout easier to follow.
4. We outsource our billing, however I understand improvements have requested for the billing section. For instance, the receptionist sould be able to charge co pay, make the notation for what patient came ex office visit, vaccination, DXA, EKG, blood work etc,before the patien sees the doctor. I can not make any other comments on this section.
5. Ability to costumize the imported items Folders.

There are many more but I have to answer at 3 pages I just got in the past 15 min. To be continue..

Thank you to Jon and all Amazing Chart Family

1) Perhaps there is a way to do this that is fairly straight forward, and Maybe I'm not as savy a user as I should be, seeing that I am a PM and not a provider, but... We are now in the midst of a P4P issue with Aetna for tracking tests and orders for these test? Not the values in the tracked data section, that we know about and use. Instead our new P4P is for the actual test and it's results of things like colon cancer screenings, labs and the like. Now is there an easy, straight up way, ala "reminder" to follow up with orders written, referals created, lab test requested or orders sent with patient, so when Mr Jone's labs or test results don't come back in a week or two, that we know to start looking for them. And Just as Importantly, somehow have the return of results relate back to the original orders written, and be recorded that we recieved them, called, wrote or scheduled a F/U visit with, for, or to the patient about the results or reports. I guess saved to a new special part of the chart for such things perhaps in tracked items of the summary section? Oh, and they want to track, and therefore punish or reward "formulary compliance" too. Good luck figuring out how to track that in a simple EMR or small office. Good Greif.

The patient may have missed the appointment or not followed thru on the Blood Work order we sent them out with even. But now we have to be their "Den Mother" and hold these people's hands, to get them to hopefully follow thru with good common sense tests and screenings? Where is this grown adult's responsibility to do the right thing or accept the consequences of their lack of pro-active actions? But I digress here, We need a good, simple way to track these things, follow up on these things, both for patient care and ever increasing over-site and to defend ourselves against the onslaught of legal action.

2) I have asked for this before. For those who have used QuickBooks, Intuit has always had a very simple way to make back-ups that are properly saved and formatted, for easy re-installation of your data back to a good copy of the program. They have a simple little icon of a disk, you point and click, follow along and choose one or two options as to where to save the back-up, and as Bullwinkle would say... "Presto", a perfect back-up in just the format the program likes best. And restoring one's "company" is just as easy because it is in just the perfect format that the program likes best. It even has a choice to check the data's integrity (which adds a small amount of time to the back-up, but obviously is well worth it) too.

I have had the program "flag" my data less than a handful of times over the course of three years now, for some sort of an issue. And just like AC it has an Amazing Utility type thing too, that checks your data, cleans it up, and then you can go back to making a good clean back-up. BUT, right now the only way to get this type of a "feature" is to subscribe to the off-site back-up service. And I'm still not sure that the "service" checks and verifies the integrity of your data; which obviously is paramount once you put all your charts and things into a single database and format, right? Lastly, good off-site back-up may be a very valid thing to do, but I would still like to be able to have a properly formatted, immediately accessible, integrity verified, back-up feature, that I can save to any media that I so choose, whether or not it is in conjuction with the off-site back-up service. Most of the PM modules like Altapoint seem to believe in this feature too, so please AC...
Thanks for Listening Vinny
Paul

Romel,

Thanks for the ideas! I've been doing a LOT with the medications form, and I'm going to present the patchs to Jon with the hope that he'll accept them upstream.

One of the features is context sensitive pull-downs, which change based on the medication. There is a decision tree to determine the medication's use, and load the pull downs. Tablets say Tablets, Capsules says Capsules - with all the usual instructions. If a topical it'll say to apply to affected area daily, QAM, QPM, BID, etc. Eye and ear meds have appropriate entries. Injectables force to an empty pull-down to prevent dangerous mistakes - although this may change. I'm kinda proud of this and hope Jon incorporates it.

Current e-prescribing interface is pretty bad, in my not-so-humble opinion. I'd need to look at the programming interface for eRxnow to see how big a headache integrating would be. One of the many things I dislike about the current e-prescribing provider is that it's an embedded web page interface, is slow and klunky, and a busy doctor doesn't have time to waste with it.

The number of days and have it expire idea is great! I've toyed with this myself, and have some ideas, but handling the expiration I'm still not sure about. One possibility is to have a flag for episodic medications, and separate how they're listed on the chart note, so on the NEXT note if they're missing (because they expired) people won't wonder where they went. THIS one is on my PERSONAL "to-do" list, so if Jon doesn't take it over, I'll write it for him and then pitch the patch to him.

If you really have a 3 page list, PM it to me when you can. Our meeting with Jon is MONDAY.

Warmest Regards,

V.

Vinny,

I think he meant 3 pages as in 3 pages to his beeper, lol. If he didn't have those to answer, he would have sent more. <G>

OK. If you pull this one off, I will NEVER EVER EVER ask for anything else and NEVER EVER EVER complaint again. OK, wel maybe -- I can't give up that right.

Vinny, currently, I would like nothing more to do than to print out CII such as Concerta and Percocet. Since AmazingCharts, my call back rate from the pharmacy on printed scripts is < 1%. But, it is still around 5% to 7% on stimulants, et al. Now some of this is due to the Maine's infamous Preferred Drug List and PA which states intelligent things like you can not write for two drugs of the same strength, i.e. You cannot write for Focalin XR 20 mg, 2 po daily; you must write for Focalin XR 30 mg and Focalin XR 10 mg. The same holds true for Concerta and 36 mg. I have no idea why.

So, I would like to utilize the custom scripts by going into Administration and choosing the Preferences tab and changing the script format. But, to get there from the chart, it takes at least five clicks, which is not feasible. Plus, that format then becomes the default format until someone changes it and restarts AC.

Is there any way to change this from being ad administrative change to just a regular one. Put the change prescription format icon directly next to the Search icon. Once click, in the window, then out. This would be so awesome.

By the way, I just noticed after, I don't knnow, forever; that there is a little yellow "sun" icon just above the schedule icon when you open a patient's chart, which goes away when you close the chart. Pretty cool. How is that helpful, though? Just to tell you there is a chart open?

The Sun! I just thought it was to remind those of us in rain country that the sun does truly exists!

Seriously...I've been wondering the same thing.

What I would like, and would save me time is a better format in the prescription writer. I realize that the combo meds come up funny because of the access database, but really, it's not how medications are written. I would also like to get rid of the multiple choices for the same medicaitons.

Barbara

Yes, Yes. YES!!!
I think Amazingchart needs to go back to the basics.

1. Clean up the medication database. I have been spending several hours on this and am willing to share the work in progress. I want to get rid of misspellings, ridiculous dosages (often with incorrect units), and a bunch of really bizarre non-medications that is in the medication list. This is the only database element open for users (need to use Access 2000 or above). I was told by Amazingcharts technical support that altering the medication database would cause Amazingcharts to work improperly. I'm happy to say that they have been wrong so far. I removed entire sections/fields not relavent to prescribing and I must say things now work faster and better! I wonder if technical support says this because that is what they are told or they say this to keep us users in the dark. I'm afraid that if this database is not maintained, there will be a greater chance of serious errors resulting (like Levothyroxine 200 grams --although no pharmacy will dispense this, I hope).

2. The CPT code should be made adaptable for each practice to edit out (through the database) codes that does not make sense to their practice. For example, there are many immunization combinations which are not available. It takes time to sort through the choices to get the correct one (like Peditrix).

3. The ICD codes contain codes that will result in rejection if submitted to the insurance company. And who really needs 500 codes for tuberculosis!!! I haven't seen an actual case of TB in the 12 years of practice!! And I haven't had any patient get injured off a falling part of a spacecraft. And I haven't recently performed a legal execution (and I used to be the medical director of a state prison)!!!

4. There appears to be no way of correcting erroneous inputs that my employees make. For example, a vaccination that is originally entered improperly gets perpetuated until the end of time because the drop down menu keeps showing the erroneous entry. I'd like to lock out potential entries (or at least edit them) otherwise the entry for Upjohn will remain "Outjohn" forever.

These changes will reduce errors being made and I believe should take priority over the many other worthwhile suggestions that are being made.

Roy

Roy...I completely agree.

I'd also add being able to edit/correct insurance companies. We've had differrent people enter in different names - and now in order see how many folks we have on Medicaid, I need to search Medicaid, DSHS, Department of Social and Health Services, Welfare, etc. While we've since trained each person to use a set of standardized names, all this is still there and comes up in the drop down menu.

Diagnostic codes...The only thing I can add to what Roy has said is that even when I make a dx inactive, it still shows up on the drop down menu for that pt - which only keeps things cluttered.

I'd love to be able to edit these databases (if I knew how...it would be such a timesaver), however, how would I prevent an update from overwriting my work?

Barbara
(the Sun is shining on the WA Coast this morning!)

I must agree with several of the above. The ability to edit the insurances would be great. You would be surprised how many creative ways the staff spells medicaid. To export it to a billing module will require about a dozen edits so that they all go to the right place.
The ability to lock the desktop from the AC desktop, not a patient note. If we finish a note, all the patient info can be looked at when a new patient is put in the room unless the screen is locked. I use webshots and control+alt+S to lock the screen but a button would make it easier.
More spaces for the common code buttons. As a Pediatrician, just immunizations use up all the 10 codes and more would speed up billing.
Graphing growth charts went dog slow in version 3, any way to speed it up?
Template visits, not just sections. I would love to have a template 2,4,6 ect. month visits rather than alt clicking 4-6 boxes.
I think those will keep you busy, but I will try to come up with a few more.

Vinny,
Here is an old one that needs to be reconsidered. As a PCP yourself, as you well know we get many people who call or are assigned to us by an HMO or what have you, but who never actually establish with a proper first visit. But none the less, many of these "potential new patients" are still possible liability issues that we need to chart and track their phone and mailed interactions with us. Things like always re-sceduling and no showing, papers and ER visits sent to our office even though we haven't a clue who this patient really is.

What we have requested is to have AC have a sort of divided data base with TWO separate sets of chart numbers as well as all other data. This way when a new patient calls and we book them an appointment or start them a chart, they are a temp chart number, not a regular est'ed chart number. So like TP123. Then if and when this patient does have a real estlishing visit, then we can hit a botton on the demographics page and make them part of the regular patient database. AT THAT TIME, then AC can assign them their in proper sequence, regular patient chart number AC456 or what have you. Right now we have an extra false patient, named "New Patient" and we use him for our new patient slots as a place holder. We enter the real patients Name in the comments area so we know who should be in there, and then when they show up and complete our intake, then we remove that temporary place holder and then put the real patient in their proper place on the schedule, so that all visits are properly associated with that person.

But in this way that I suggest, we can have two sets of data going so that these never establised patients can be tracked in and of themselves, and their squewed data is not messing up all of our regular charts and data. I know that there are many practices like us who are NOT starting people charts if and until they actually establish for just such reasons. But we need to document their behavior with us for all sorts of reasons and purposes. And we can still start and record things for these never establised people to document what we have done with or for them, their history of no-shows or what have you. Very Important.

Vinny,
Don't shoot me, but here's another really important idea that I think that Burt would agree with because he seems to chart in a fashion similar to my wife. Complete 3/4's of the encounter, but doesn't want to "lock it in right away" so they sit almost complete in the in-box. Sooooo, what we need is a way to add a small amount to an already signed encounter and the ability to "strike a line" thru "it", what ever "it" is. I know that the line issue was once under consideration from Jon and AC but it never seemed to get there.

But, docs in paper offices go back to a chart a few minutes, hours, or days later and add a note to an encounter as they deem needed or something new pops up. It's not a new encounter, and it's not a full addendum either, it's an extra few lines about that last encounter or a new thing or two that have come to light about that encounter, that actually make sense to be "tied" to that encounter anyway. Doc's correct paper charts with lines thru things, initials and a date all the time. Again an electronic system that "charts the way doctors do" should be able to do the same, right?

I'd be willing to bet that many AC users would have in-boxes with a whole lot less 3/4's completed charts in them, if they felt they could go back and add or fix one or two little items easily and legally, like in a paper chart.

Lastly, being able to change the date on an encounter, with a documented trail as to why is really very over due as well. Many nights Nancy is here charting late into the night and honestly saves an encounter for the date that it presently is, not the DOS that she was documenting. This too needs an easy paper office like, correction options. Thanks much.
Paul

A very easy and inexpensive way to get templates into AC is to use the program Shortkeys (www.shortkeys.com) simultaneously. For instance, you can macro a routine 6 month visit in Shortkeys and then use hotkeyes, such as h6 (for the 6 month history), pe6 (for the 6 month physical). I have found this program to be invaluable to me when using AC.

Speaking of erroneous entries by staff. Does anyone know how to remove the wrong insurance names that are misspelled or addresses that are incorrect?
Is there a way to have more than one fee schedule?
Can modifiers be entered instead of only choosing from a dropdown list?
Can I have the flexibility to add more fields to the vitals area and graph it to use with my obstetrical patients, i.e. fundal height and fetal heart tones?
Is there a way to document cash pay patients and not just show up as copays and detail what form of payment?
Oh, and can't wait to try the Quest Lab interface! Hope it is bidirectional, has anyone tried it yet?

Reply from Dr. Bertman
"Currently the insurance entries are unique entries from some patient charts. We are actually fixing this to tie to verified entries, and this release is due out this fall sometime. In the meantime, you would search for the misspelled item in the Search Window and fix it in any affected charts, and this would remove it from being an option."

Thought this would be useful to share.

FYI for everyone,
This fix that Roy speaks of works for all the self generated drop down boxes. I thought most folks knew this already. We have had many mis-entered "states" in the demographic section. D0 the search as Roy suggests, correct the few that have what you want to get rid of, and now that particular option is gone until you enter it by accident again (hopefully not).

OK everyone:

To Rainy: Will someone tell us what the little sun is for?

To Leslie: I agree. Shortkeys is awesome. I always wish we could do like Microsoft and just incorporte these programs into AC. Well, not the actual copyrighted version...

To DrWAW: I agree about the lock feature being on the main window. I may have something that you will like better if you use XP. I have no idea how I came across this little bit of Micrososft trivia, but I will try to share it. Actually, I posted it before the crash once..

%windir%\system32\rundll32.exe user32.dll,LockWorkStation

1. Right-click on desktop
2. Choose New -> Shortcut
3. Copy and paste the above snippet of code into the "Type the location of the item" box
4. Click next
5. Type a name such as Lock Computer or Lock or whatever you want
6. Click finish

Clicking this will instantly lock your desktop.

I also recommend choosing properties and change icon and searching through the System32 folder and using the Safe or Keys icons. It makes it kind of cool and obvious what it does. This, of course, is the controlling part of me.

Now, for the best part. And, you have to choose a function key that isn't used for any other program such as F7 for us. Right click on the icon and choose properties. Click inside the Shortcut key box where it says "None." The cursor should then be blinking on the right side of the word, None. You can type and letter now and it will automatically make the combination Ctrl Alt "letter," but that's much too cumbersome. If you type one of your function keys such as F7, the F7 will replace the word, None. Click apply and OK. Now, anytime you poush the F7 key, or whatever function key you chose, you will lock your screen.

Hope this helps.

And remember, you can't "push" the key, you have to "poush" the key.

I would like once more to ask Vinny create an icon or button on the main screen or on the script writer to allow one-click changing between print formats, i.e. 4 by 6 or 8 1/2 by 11.

And, while we are all referencing the prescription writer, here is something I have wanted forever. At the present, you can see the active meds in the script writer, and you can click to inactive meds. You can even click on All meds and get a complete list.

I see many patients as I am sure many of you do that are on a lot of meds and a lot of changing medications. Especially patients on psychotropic medications. For example, I may have a 13 year old on Abilify, Concerta and Wellbutrin. In the past, they have been on and failed Seroquel, Focalin XR, Zoloft and Remeron. In the current format, as you are interviewing the patient and trying to come up with a different medication regimen, when you consider other medications, you have to constantly click over to inactive medications. Many times I forget to do this, and I suggest we try Seroquel, and the parent looks at me and tells me, "We tried Seroquel and he had this horrible dystonic reaction." I know -- Abilify probably wouldn't have been a good choice, lol. But, it's embarrassing to offer medication choices that have been used in the past. And, going back and forth is problematic. Even if you choose all medications, they get listed alphabetically and not by active and inactive. Even putting the active on top and the inactive on the botton and highlighting one set would be helpful. But, if we overhaul the script writer, I would suggest have two lists visible at all times: The active meds and the inactive meds. Or have a choice to show all of the inactive medications. Also, the way it is now, when you write a comment, you can only see it by highlighting the medication. I would propose that the list of inactive medications have the comment next to them so you could see that Zolft didn't work and Remeron caused hives.

Would love to hear other comments.

Bert,

Just a quick preview from the meeting with Jon earlier this week. (More info later this weekend.. I know, but between the meetings, the drive back, then playing "catch up" after being out of the office for two days, I've been too tired to put a post together for the group)... there are changes coming for prescribing.

We discussed active vs inactive, and chronic vs episodic medications, and most likely there is going to be a way to separate these, and to expire episodic medications when they run out. (antibiotics for bronchitis, that sort of thing). That's in the planning stage.

THREE patches that he's accepting upstream from me for prescribing - the first is context sensitive medication instructions. Tablets say tablets. Capsules say capsules. If it's a topical, the directions are for topicals. Eye and ear meds have proper instructions, etc. This is done by parsing the medication name, looking for clues as to the drug type and route. While it may not ALWAYS be 100% right, I think the decision tree I use to parse this does a pretty good job - high 90's at least. The occasional mistake you type what you want, and it remains on your "hot list", so not that great a problem on the rare occasion it's wrong. The second one FINALLY fixes the bug where you don't see the current allergies, you see the allergies from the LAST SAVED CHART NOTE. The third patch to the meds passes the CHART NOTE DATE to the prescription form, not TODAY's date. If you're doing a catch-up note, it means that you won't screw up your history data if you forget to change the prescription date. Also, last Rx date was ALWAYS today's date, rather than the Rx date. Not a problem if the Rx has today's date, but otherwise was doing the math wrong. Based on my meeting with Jon on Tuesday where I reviewed patches with him, he likes these.

I think that the yellow line on the Rx form is a good place for putting in the reaction, etc, on a discontinued med. Would be cool if we could bring this up as a tool tip - show it by hovering the mouse over the med rather than having to click on it.. but I don't know how do-able this is. I'll look into it. Being able to say to the patient "Well, we tried you on X and you got hives, and Y gave you the screaming awfuls, lets try Z" would be pretty damn impressive!

Bert, when you switch back and forth, do you ever have to change the number of "twips" to shift the form? If the answer to this is "NO" then I think what you're asking is a pretty easy hack. I'd have to change the setup screen to be check boxes of what forms to allow, rather than radio buttons, then have the checked forms be radio buttons at print time. (I'd rather NOT have EVERY form be available EVERY time you print - would be a BIG pop-up ! Let me think about the best approach to this one for a couple days. Would be handy, and I think pretty easy to bang out.

Gang, it's been an exhausting week. I'll try VERY HARD to write up more about what happened this week.. to keep your interest here's a little teaser :-) we discussed the design of practice management, billing and insurance verification, more patches, a new template management system with Treeview controls and drag-and-drop to organized your template collection, and lots of other goodies. We also had fun updating the board with the new version of UBBthreads, and the new WIKI for creating a decent Amazing Charts user guide / help section.

Be well, folks.. more soon.

V.

wow, thank you VERY much!
Lisa

Yes, wow. Thanks always, Vinny. That's why I listed you #2 on the top 100 list. I'm thinking I may have to move you to #1. I will look at the "twips" and make sure we are both talking apples apples to oranges. Also, the tool tip would be awesome and just what I was looking for. It would be damned impressive to always know why a medication was disconnected. I would think that if a psychiatrist used this program, he or she would have to be able to see both active and inactive medications as psychotropics tend to be hit or miss at times. You know, Abilify is awful by Seroquel works perfectly.

I hope your parsing method gets in there. I know it has been your project for awhile.

Take care. I will get back to you.

Vinny,

By the way, if you pull off the hack on printing controlled substances vs 8 1/2 by 11, are you gonna hold me to my promise of never asking for anything else? <G>

Vinny,
Here's another one that although not extremely critical it sure would make AC friendlier and save staff time. We are in FP like you and so we have many patients in the same family with basically all the same patient demographics. It sure would be nice to have a button like option to copy all that data, Insurance and address and the like to start a new patient and then just add their unique stuff like name and DOB.

More importantly, is having family members "tied" together some how so we can quickly see which of all our "smiths" are in the same clan and remind us of such things like when; "Hi this is Rich Smith, my wife asked me to call and ask you to re-fill her Lexipro Rx for her"... Now by clicking on him and highlighting him AC would only show me the other members of his family and I could quickly know that only Suzy Smith who's 41 years old is his wife and not my other about the same aged Kathy Smith, let's say. Better still if when one clicks on any family member all family members that we have chosen to tie together then get shown, same last name or not. We've got a number of families that have kids who have multiple last names, all of them not the same as either the "mom or dad" and boy is it hard to recall that Suzy Smith is the mom of James Jones and Lisa Little. This would make us look so good in front of our patients and save us much frustration and time trying to remeber who goes with who... PLEEEEAAASSSE!!!!! Thank you very much....

Happy 4th Everyone from Paul and Nancy!

WOW great help, I had missed this before. Has been a busy week and I never had a chance to check the board until today. Thanks Bert.

When we compose a letter in AC, it is saved as a web page (or something). If I need to reprint it, it then has some "web page stuff" at the bottom.

It would be nice if AC saved these letters as, oh, even a Rich Text Format would be good. Then it could be reprinted if necessary and still look like a letter.

I absolutely agree. They look real "toy" when re-printed right now. Would this be a hard fix Vinny?
Paul

Hmm.. dunno. Part of this sounds like a bug, and some if this sounds like it would be a nice addition.

I'm in the process of packaging up patches for Jon that I have to get to him this week if they're going to make it to the next beta.. remind me by PM in about a week and a half and I'll see what's what in that part of the code.

Regards,

V.

Hey folks, first-time poster here. I have been learning about AC for a couple of months and will be going live next month. I have been reading through the archives and haven't found anything *exactly* like this, so here goes:

I am already experiencing some of the headaches which have to do with the medication database (duplication, misspelings, etc.) I only use a *small* fraction of the existing meds. Such a small fraction in fact, that it would be a lot easier for me if I could just disable the existing AmazingMeds database, and start over from scratch (as opposed to learning how to use Microsoft Access and deleting med after med after med).

To that end, I would like a function that would automatically populate the database with the prescriptions I write every day. In other words, each time I write a prescription that I commonly use, I would like to be able to press a button and add it to my medical database the same way I populate my clinic notes with macros of commonly used phrases. I estimate that within a few months, my database would be populated with 90% of the medications that I commonly use.

Has anyone else ever suggested this? Is there a way to do this that I just haven't found? Thanks for your consideration.

Sincerely,
J. Brian Cotner, M.D.
Solo F.P. since 2003

Here are a few more suggestions. Some of these may just be things that could be added to the current version, but here ya go.

1) It would be nice if we could print out entries from the built-in rolodex. Right now we have to add all new specialists in two places-- AC and into our contact mgr (Outlook). It would be great if I could print from AC the contact info for a specialist for the patient.
2) Can we add the telephone number of the specialist to the letter writer? This way, when we write a letter the specialist's phone # shows up below their address. This allows hte patient to just look at the letter to call for the appt.

3)Can we have an option to change the size of the print on-screen? All of us don't have "young eyes" you know.

4) Ok. I'm going to keep saying this until someone jumps out of my PC screen and raps me across the hands. When scanning (not importing a file) we need to have access to the Non-Medical folder to prevent generation of useless sign-off messages. I had to add a false-doctor just for this, but you stil have to get the staff to remember to send it there. Scanning should operate just like importing a file for these purposes.

5)Did I see a comment about automatic insurance verification? Sounds nice, but seems like something that the billing services usually offer.

6)Interfaces to the physician websites and secure messaging facilities available through Medem, RelayHealth, and MedFusion. Medfusion offers free websites to AAFP members. RelayHealth has secure messaging and online consultation services available through a physician website. Empire BCBS and GHI both reimburse $25 for online consultations through RelayHealth. The site costs $22/month.

Give me a few days and I may come up with some additional suggestions. I'm trying not to just repeat what others have already suggested.

I knew if I sat around I'd think of something else sooner or later (but I expected later).

I frequently see references by various other vendors or labs that they can interface with any EMR that is "HL7" compliant. Now, I don't know the first thing about the HL7 standard, but it seems as if this would be good for AC (and the rest of us). For example, RelayHealth, which I mentioned earlier and whose rep I met with today, says that they can "interoperate" with EMRs that are HL7 compliant. Granted, they may be overstating their case, but is AC? The ability to integrate the offerings of a company like theirs with AC might help operations for small offices.

J. Brian,

Welcome to AC. I am not aware of anyway to change the database directly from AmazingCharts, i.e. write a script and then choose add to database. You must edit the Access database. Microsoft Access can be daunting -- I am currently looking at a book on Access on my bookshelf which is almost as big as a PDR and probably less helpful <G>. Making large databases using Access takes some time, but editing the database takes less than five minutes to learn. Basically, you open it and edit it. Again, as I have stated in the past, there is a step there that must be done in order for the changes to save.

The only other change you can make to the AC medication scheme is to change it in the Windows registry directly. When you write a medication on a specific computer, it is saved to the registry. A total of 54 each of the medications and strength, sig, amount dispensed and number of refills are saved to the registry of the computer you are on. Each time you write a new script, those four components occupy the zero spot of the med list as MedList0, zero spot of Number dispensed as NoList0. Concurrently, #53 is deleted.

Of course, editing these would really serve no purpose as they are constantly being replaced. The only reason I used to edit the registry was at my last job, I almost always used the same three room and thus the same three computers while my partner used the other three. Because, I am OCD, I want Concerta to read Concerta extended-release tablets and to be spelled correctly. So, if I happened to type Conc..., then it would populate the medication box. But, my partner was not OCD or was on Luvox, lol (Just kidding), so he would write Conserta. Since if he wrote just one more prescription, Conserta would then move to MedList1, it would take 53 more scripts before it thankfully fell off the PC. So, when he used my rooms, I would go in and delete them at the end of the day. And, I wonder why I am here until 1AM <G>

Sorry about the longwinded answer. The short answer is I am not sure if anyone else has ever suggested it, but, no, you can't do it.

Cheers!

Wcoghill,

I shouldn't even try to answer this question, but my understanding is just any company which wishes to exchange data with an application like an EMR uses the Health Level 7 to do so. In our area, we could choose to interface with ALI using HL7 for a one-time fee of around $5,000. I know in some cities that fee can be waived for communication with a lab if there are many competing labs since they want you business.

This is where I certainly may be wrong, but my guess is that all of the links that Jon provides in the administrative section use HL7 and that AC is likely to be HL7 compliant. There are also companies which provide software when the certain version of HL7 is not compatible such as Chameleon and Iguana. I don't know the specifics but I would think that Jon has to figure out the ins and outs of the links to these various companies.

Vinny, correct me if I am completely off base. : )

OK. I'm coming out of the closet.

I'm OCD too.
I can't find where on Windows registry I can find the medication list.

Tried regedit and search but could not find where the data is located.

Thanks

HKCU -- Software -- VB and VBA Program Settings -- Amazing Charts -- Username

I heartily second the suggestion to interface with Relay Health; it's a great system and it would make life a lot easier if it interfaced with AC.
Also, I'm one of those with not so young eyes and would really appreciate being able to have a larger font when working on notes. Sometimes I have mistakes because I just can't see if I've typed one letter or 2. And yes, it's true that I could wear glasses but I don't need them otherwise.
Thanks
Lisa

Well, after some thought I've come up with another wish list item. But it may seem kind of "out there."

If AC would count up the number of Appointments for a given date range to be included in one of its canned reports I'd find it helpful. In a perfect world, all cancellations and no-shows would be removed from the schedule. And all charts would be written up while still with the patient (or at least by day's end) Alas, it is not the case. I'd like to be able to verify the number of appointments on the calender (for a week or a month) against the number of charts signed. Would help me understand if (and how far) the doctor is behind in charting, and what the implication is to cash flow. Once I determine the implications, I take them to her. I just went into the financial section of the Admin Options. If I run a summary report, it will tell me the number of charts signed off (by name) during that period. But I can't get a summary of the calender. Oh, I can print off the calender, but before I compare name by name and date by date, a simple comparison of counts (210 appointments vs. 205 signed charts for example) would be nice.

I am not completely sure what you are trying to accomplish, but wouldn't the total number of patients signed off be found more easily by clicking Ctrl-D, setting the date range and clicking pull bills.

I am not sure how you keep a chart that has not been signed (since I sign all charts prior to leaving the room), but don't you have to forward them back to yourself. The total number of charts from the billing figure minus the charts in your Inbox should give you the number of patients seen without being signed.

Again, not knowing how AC users forward the charts back to themselves and without thinking much about it, I guess if it were a common occurrence in my office, I would forward them to a user named "Charts" with full privilegs and, of course, with the workaround so my name would appear on everything. This would keep all my unsigned charts in one place, and I could see the total at anytime by looking in my Outbox.

Hope this helps.

Well, I didnt know about the control-D trick. That helps me a little. I dont have to go into Admin now.

The doctor forwards the charts to herself and them tries the finish them later that day. Or w/n a few days. But I would like to check against the schedule so I see how well she is keeping up and try to nudge her a little now and then if she has fallen behind. I know that the schedule reflects our encounters and so we should have as many appointments on the schedule as we have signed charts (once they are all done.)