Home Forums Discussions Problems office notes missing

I discovered that on rare occasions the office visit note dissapeared after I signed the note. The office superbill was saved, but the office visit note associated with this superbill was gone as if never existed.

This is a really serious glitch which could lead to increased liablity, audits and even lasuits because of missing records and submitting claims w/o any records of patient visit. I don't know how many such events had happened in the past, because you don't know if your note is saved or not unless you go back and look for the saved note. I accidently discovered two such events over the last month.

Although time consuming, I would have to go back day by day and examine several years of my practice to see how many records are missing and hopefully recreate them.

To avoid losing a note, I have to forward the complete note to myself before signing it, then open it w/o deleting from inbox, then sign it, then go back and make sure it saved before deleting the draft.

I believe this is very important security issue which needs to be addressed. I am still using version 3.7.15.

I think you should at least subscribe to guardian angel support and upgrade to version 4. So many changes have been done and Jon actually has just started putting the line - multiple bugs have been fixed in this release.

I don't believe I have ever lost a note and so before you worry you at least need to go up the most current version. The jump to version 4 can be difficult so don't try to do it over lunch - if you are nervous get in touch with support and try to set a time you might be closed to do it.

I have lost a few encounter notes, (not the whole chart),when I started off in AC last year using V4 something I lost many notes, one day most all of the notes went missing. It quickly became less and then stopped happening. Currently I am using V5.0.22 and lost a note in the middle of last week.
There are a couple of ways to lose a note and I think that it is more likely to be user error than a true bug.
I wonder if the reporting feature in V5 could be used to monitor this...a report with search criteria of patients seen on the last day who do not have XXXX (an assessment or plan or Vitals or something tied to the encounter) for that date of service. Because of the missing note last week one of my office staff takes 5 minutes at the beginning of each day to check yesterday's charts and see if the visit history includes the most recent note. The plan is to let me know if I lost a note so that it can be redone while fresher in memory.
Not to belittle the problem, but paper charts are suceptible to AWOL issues also, in fact, they are often a pain in the neck to find them when you need them.

I am supscribed to guardian angel support, but I am not in a hurry to update to version 4 because of multiple bugs and problems reported by other members on the board. Also, version 4 doesn't support Windows Image Acquisition (WIA) scanner interface, but only Twain. My employees really like WIA.

Billing Medicare w/o proper documentation to "justify" office charges is considered a Medicare fraud. Lost encounter notes may result in thousands of dollars taken away by Medicare and other insurances as "overpayment".

"Starting in January 2010, Medicare's Recovery Audit Contractors (RACs) will begin conducting audits of Medicare fee-for-service claims throughout the United States...
...If your claims are audited by a RAC or Medicare and you lack the documentation for the services provided, as far as the auditors are concerned, the services never occurred."

I'm wondering if there is a way to resurrect an encounter that is inadvertently closed before it is signed. I hate having to reconstruct the whole thing. While multitasking I have more than once inadvertently closed an unsigned note losing everything. Any advise out there? If it has been sent to a mailbox I know it can be resurrected but I don't know how otherwise.

go to deleted items and it will be there, but it back in your in box. This only works until you closedown Amazing Charts on the computer you were working on. This will at least bring back the information that was sent to you. For example, my medical assistant puts in vitals etc., and I can get these back, also diagnoses and medications or ghosts of them stay.I also would like to be able to get back chart that have been inadvertently closed without losing anything.

1. If it has been sent to your inbox and you open it, but don't delete it from the inbox when it gives you the option, it will default back to there.
2. If it is in your inbox, and you open it and choose to delete it from the inbox (which I do), if you inadvertently close it, it will be in the deleted items, and you can get it from there.
3. If you open it from the Patient List and type in 25 paragraphs and inadvertently close it, it's gone forever.
4. If you open it from the Patient List and type in 25 paragraphs or whatever and AC crashes, it will ressurect from the backup in Notepad.
5. If any chart is in deleted items, if you close Amazing Charts, they will all be gone.
6. If any chart is in deleted items, and any of your colleagues or staff close Amazing Charts, they will be gone in all other AC programs.

At least in earlier (pre-4) versions of AC, if you inadvertently close a note (or it crashed) you could go into your local AC files (C:\Program Files\Amazing Charts) and see the LastNoteBackup.txt file. I would rename it, so that it is not overwritten when you open the chart again in AC. Sometimes it wouldn't resurrect as it was supposed to, and once you open another chart, the data is gone. With the txt file open, you could cut and paste the 25 paragraphs you had written. I'm not sure if the same applies to V4 and 5.

I don't think you could ever resurrect it from that file IF you inadvertently closed it. I believe (correct me if I am wrong) that the LastNoteBackup.txt file only works IF the program crashes while you were writing a note.

OK verified:

If you are writing a note and inadvertently lose it, close it or open another chart and lose it, it will NOT be resurrected.

If you write a note (you can try this), and click on the red x on the entire AC program taking everything with it, when you restart, you will be given the option to resurrect your note.

HTH

It won't take the actions to resurrect the note, because the program mistakenly believes you intended to close the note. The LastNoteBackup.txt file will be there with the last info entered. You can't force it to take the "resurrect" action. But once you open the chart again, that info is erased and the current open chart's info is put into that backup file.
So, if you are lucky enough to realize that you closed chart/note you didn't mean to, you immediately find that file, rename it to something like LastNoteBackupJaneDoe (so it will still be there when you open Jane's file) and cut/paste the data. This even worked when asked if you really do want to close the note chart. The problem, though, is that if you didn't quite catch the fact that the note accidentally closed, and you went on to other charts... those 25 paragraphs are gone.

Bert, your own response to your post beat mine... but I'll leave mine here anyway.

Thanks. Learn something new everyday. I didn't realize the info would be there. On the other hand, unless the program crashes, it won't tell you about the chance to resurrect it.

I think the bottom line (before users get tired of hearing this topic -- or at least me) if you lose a note in any fashion, check the last note backed up note.txt before going on. Especially, if you wrote the Declaration of Independence.

It should be noted that all of this takes place locally and not on the server.

Bert,

You mean if someone logs off your user account ON THAT COMPUTER, it erases the Deleted Items when you log back on that same computer, right? I will have to confirm this, but I think I have been able to retrieve Deleted Items on another networked computer that has remained logged onto my account in a different room. I will try to confirm this when I get back to the office.

I have experimented with this, and what I have found is that if ANYONE shuts down ANY Amazing Charts program, the deleted items are wiped away for all computers.

When you think about it, those charts are located on the server, are they not. They couldn't be located locally. Therefore, they would have to wiped out by anyone.

Easy enough to check though. I would be interested to see your results.