Home Forums Discussions General Discussion Thinking about getting AC - have questions

Yeah, I think Wendell's got it. That way you won't have charts in each docs inbox. I guess I was unaware of how easy it is to log in and out of AC so quickly since I never do that. I was under the impression that you would have to close the entire program and re-open it which is SO much slower.

So that still puts you at putting Dragon on each desktop in the rooms and microphone.

I do paper superbills as well. One piece of paper with so much information and so efficient.

I guess that's why they call it a Superbill. That's starting to sound like Elton John.

I thought about this and decided to check - better solution - forward CHART to providers inbox (group box for providers). Then any provider can look in PROVIDERS box (go to e-mail, go up to where it says INBOX and choose Providers) Then you can pull in chart - ask if you want to delete from mailbox and go about your day.

This lets MA just enter info and generically forward - provider who sees pt. pulls the chart and completes. I thought you could do this but did not want to put my foot in it until I tested.

P.S. I also use a superbill - just write my diagnoses from AC, circle bill and give to billing.

I thought I already said that. The only reason I made it a separate inbox, is you will have to be able to send messages to each doctor unless you want everything in the same box.

The inboxes are now set up with a generic PROVIDERS, FRONTDESK,NURSING, etc which lets you send a message and any one assigned to that group can look and pick up. It is good so if you have 2 MA's they can each look in call backs, etc and do it when avaiable. Otherwise most of us end up sending it to one staffer we know will do it and then that person gets overworked.

Hey Bert...You don't even have to have a "dummy physician" with Steven's suggestion. The MA can simply send it to "providers" inbox which is available to all providers. So whichever doc is logged in (under their own Logon) can just pull the patient from the "Group Providers" inbox and delete it. Works awesome.

I trust you Steven but I had to try it out myself to see how it works.

I learn some little intricacy every week on these boards. Not that I'll every use this one but it helps to know the ins and outs of AC.

Ahh, Travis, come work with me, and we can use it.

Wow!!!!

You guys are great. Here I don't even have AC yet and already I am getting solutions! Wonderful... I am trying to anticipate the stuff my partner/Medical Director is going to ask me about AC. He knows of my enthusiasm for the program and is very interested in it. I want to convince him that it's the one to go with. He is a very thrifty guy, so that's on my side

As far as having Dragon in every room, I won't need to do that if I simply carry along my own little netbook that it's installed on. The others can either type/mouse click, OR...aren't there now touchscreen computers out there? Has anyone tried using AC with a stylus (or very pointy finger) on a touchscreen? If that is possible, that will REALLY open up the door for AC to be used. I just know that of a couple of my partners would really cotton to that...

Melanie,
Also look at an inexpensive program called Shortkeys (www.shortkeys.com). There could be standard shortkeys that all the docs could learn. It really helps to cut down on the tying and, when combined with AC templates, makes charting a breeze. It will also work with Dragon. For instance, just say "dhi space" and before your eyes will appears a phrase like "I discussed general health issues with the patient such as exercise, diet, safety, wearing of seat belts, protection from sun-exposure, and routine health maintenance for their age and gender."

Melanie,

If any of you have kids over five years old, they can come in and text/type for you at somewhere near 120 wpm.

Shortkeys? Sounds interesting....

Leslie - Wow! Shortkeys, eh? I LIKE that idea very much!!!

Bert - sorry, no kids - although I trained as an FP, my other 3 partners are IM docs, and 2 also have no kids. With no kids of my own (do 2 dogs and 2 birds count?) we are plum out of little wizard fingers that type past the speed of sound...

How could I ever know, when I blew off learning typing in high school (I wasn't going to be a secretary, for goodness sakes) that I'd be so behind the curve.

Oh well, at least my handwriting is legible and I can spell....

My mother taught typing. Those were the days you either learned it in 9th grade or you didn't. Now, we take it for granted that everyone knows.

I just had a strange though. I think some cell phone company should make one with rotary dial. Just for the nostalgia. I bet it would sell.

Bert,

Well, someone already had the general (retro) idea, if not the dial:
http://www.thinkgeek.com/interests/exclusives/8928/

(I know this, as one of their geeky customers!)

Melanie

OK, folks. Sorry if you are sick of this, but even with this trial version, there are things I cannot do...

Back to the walk-in patient issue. If there are two docs on, can AC be set up so that there are two windows for each doc - one with their appointments, and one with the list of walk-in pts? If the doc who is seeing the next walk-in can drop and drag that pt. to their appointment box, how would we go about setting up that list to leave room to add walk-ins? I am guessing that when the schedule is set up, there would have to be a few blank spaces after each appointment, a space where would we be dropping the walk-in pt to? Does the scheduler allow that?
Along those lines, is it possible to create a list of pts. reflecting their time of registration, rather than the standard appointment time slots? We may have 4 pts. walk in at 10 AM. Obviously, they are registered one by one - is the AC scheduler flexible enough to let the front desk log the walk-ins by their registration time instead of an appointment time? In other words, instead of having the 10:00, 10:15, 10:30 slots (as the appointments do) can the walk-in list show patients listed as 10:05, 10:07, 10:09, etc?

Well, this is pretty embarrassing. I never realized that I could click on the administration window and use my password to actually create a schedule! So I created two other providers, one of which was a dummy Doc where I listed all the walk-in patients. This would simulate a real day in the office, with two doctors and the list of walk-in patients. Fortunately, the optional "comment section" came in handy, because I could just type in WI and the time that the patient registered. I also gave every walk-in patient, a five minute time slot. Those two things helped to make them stand out in the schedule. The only thing it seemed that I couldn't do, was to drag and drop a walk-in patient to one of the providers schedules. Whenever I clicked on the walk-in patient, the other windows closed. It seems the only way I could get it to work was to click on the walk-in patient and actually just reschedule them to one of the other providers. A couple of extra clicks, but not too bad.
Does anyone see an easier way for me to do this, since most of you have been using the scheduler for a longer period of time?

Melanie,
As many of us have, you're learning these system as you go. AC doesn't have a big manual but with these boards and some playing with the program, you can really figure out all the ways to use the program.

With my practice version of v5 that I'm using, I configured the system like you have it set-up. 2 docs, then a provider that is labeled "Walkin Clinic". I placed patients in each clinic. I was easily able to grab a patient from the walkin clinic and drag-and-drop into a docs clinic. The windows never closed. Not sure what's happening with yours. Just make sure you have All Providers clicked at the top.

I think this is a perfect set-up for a multi-doc walk-in clinic. We have all asked for some updates to the scheduler such as color coding of the patients when they arrive, when they are roomed, and when they're gone. Most would also like a quick little check box (or something) next to their name so when they check-in, the box is clicked and documents a time of check-in. We also would like to have 30 minute appointments without the patient's name showing up 2-3 times (depending on the length of your standard appointments).

So the scheduler is not perfect. But for what you need, it should work very well with a manual documentation of check-in time in the comments section as you have suggested with a reason why they are there. i.e. 9:32 Rash

Travis,

You just read my mind!! I was just ready to ask if there is a way to tell which pts. have been roomed, and what room they are in... Since you seem to have a similar pratice set-up as ours, how do you currently do that?

(Highlighting/check boxes would be perfect!)

Melanie

I'm waiting to upgrade to v5.5 when the scheduler is updated so the appointments are highlighted and time of check-in is logged.

Well, I don't have walk-ins so yours wouldn't be as simple as mine. My M.A. prints my daily schedule at the beginning of the day and it sits at a viewable location for me near the front desk. She uses a highlighter to highlight when the patients arrive, then puts a number beside their name when roomed, blacked out when they leave.

Could we figure out some way to use AC for this? Sure. Would it be as simple? Probably not. When the names start to be color coded in AC, then I'll quit this archaic way.

So let's think. Your walk-ins are the problem using my old fashioned way. So if the front-office person puts them in the system and places time of arrival/chief complaint in the comments suggest, then you could use the former suggestion of "type of patient appointment" and have Room1 NewPt, Room2 NewPt, etc. A few more clicks for the front office to click the patient, edit the appt, and click the "Room 1, New Pt" button, but no a lot. Actually, not too bad at all. Of course, when the patient leaves, the front has to do the same thing and have an appointment called "Discharged" or "Outtahere" or whatever.

Travis,

You are right, our situation is not as simple. Our front desk is quite removed from our back office, and have no idea which pts. are being placed in which room...This is a toughie!

We currently have a rack in which the charts are stacked. One for appointments, one for walk-ins. We just grab a walk-in chart every other pt. or so.

Maybe we could keep the rack system, and have a whiteboard for each room, with the number on the top. The MAs would write the pt's last name and "A" or "WI", and then stack those in the appropriate rack. As we grabbed the board, we could stick it in the cubby outside the door - maybe have an eraser attached there to erase the name before we went into the room - then after they roomed the next pt. in that room, they would write the new name, place it back in the rack, etc..Hmmmmm...

Just musing out loud, here....!

What do you do in terms of letting the staff know what you need?Or of procedures you do? Do you use AC to send a message to the staff, or do you keep a paper superbill and write the orders on that?

Melanie

OK, so I am still trying out AC, and as I was showing it to my Medical Director, he did pick up on one thing - please tell me that there is a workaround for this, or it may be a big negative against AC

Since there are two docs working, as I have said, out of 8 rooms, we often have two pts. that we are juggling simultaneously. One is off getting an xray, so we pop in to see another pt. Or, we have a CBC waiting on one, go in to see another.

Is there NO way to minimize the window of one pt, and then open up a new window to start in on the next pt's chart? It seems to me that the only option, currently, is to have to sign, then forward the first chart, then later go into messages to retrieve it. Not good at all for us - please say that this can be made to work!!

Melanie

Are you using one computer ? You cannot open 2 charts on the same compuer- you don't sign, just forward to yourself and open the next. I think not opening 2 charts is a good thing - too easy to chart information on the wrong pt.

You can be signed into more than one computer - some people will log in multiple rooms under their name and just move from room to room.

I haven't found any of 8-9 EMRs I've tried or been demo-ed, that allows you to open more than one chart on a single computer's desktop. Anyone?

What I do is forward the chart of a patient whose visit is not finished to the "providers" box and open it back up when I am ready to add something to it, this mightalso be useful if someone else is going to take up where you left off. We use EPIC at the hospital, that is a HUGE EMR program, you can have two charts accessible through a tab at the top but not more than that. I think the ability to reopen a chart from your inbox is quite simple and avoids the potential errors related to making an entry into the wrong chart because you have more than one open.

I agree with Steven, John and Deborah,

It is not a big minus, it is a big plus. This topic comes up from time to time and I have never understood the fascination of opening more than one chart at a time. It literally takes less than 0.3 seconds to hit CTRL + S. Open the other patient's chart, see him or her, send him or her on his or her way (gotta love good English), and then open the other chart.

If you really need to have more than one chart open, then get a lot of memory and install VM on your PCs. Then you can run 2, 3 or 10 Amazing Chart programs at a time.

This may have already been addressed, but I know when I worked for a large clinic previously using Allscripts, we had to make sure to log out any time we left the room for HIPAA reasons. I doubt many patients would run over and pull up their charts or search for others, but it would likely be a HIPAA violation leaving the screen accessible. Using Ctrl S and Ctrl L to save and log out takes a second and I think is easier than grabbing the mouse and minimizing the window.

Also, with Allscripts, I don't recall that you could have 2 charts open at once but I agree having that capability may be more detrimental than good with the possibility of making mistakes. I know Allscripts had to cost exponentially more than Amazing Scripts but all the features I need are in Amazing Charts and it runs a heck of a lot faster than Allscript -- even with some wireless connections.

John,

You make some VERY good points. I actually never worry about HIPAA much, but I can't think of something more of a HIPAA violation than leaving the computer screen open.

I think locking the screen is a great idea. Did you mean Windows Key - L rather than CTRL - L? I only bring it up so others find the right shortcuts. Another benefit of locking your computer each time, is you get really good at typing your password.

The strange thing is, I would think it would be the doctors' complaining about not having two charts open and not the medical director. They are the ones that are generally concerned with HIPAA, etc.

I do the CTRL L function to log out of Amazing Charts after saving the chart to my inbox when I leave a room. I have to type my password with Amazing Charts to log back in but it takes just a second or two.

I'm in a small clinic so I'm not too worried about someone getting on the computer in the few seconds I may be out of a room, but at my previous job, I may have needed to leave the room for a few minutes to round up samples, etc. I had a patient try to log on to the internet to check email once when I was out of the room! I just think leaving Amazing Charts open if you're out of the room for any length of a time could pose some major security issues.

I leave AC open and lock the desktop (windows L) rather than close AC.
AC takes 5-10 seconds to load, the windows desktop takes 1-2 seconds and I am back where I left off. I can even leave a chart open because it cannot be seen or altered.

And yes, I have seen patients try to get on the internet if the desktop is open.

Did you mean Windows Key - L rather than CTRL - L?

I wasn't really debating,just mentioning that on an XP Pro machine, you have to use the Windows Key and L to lock the desktop and not CTRL - L.

I'm with Wendell, though. Much quicker to lock the desktop. In fact, I may not log off (which I should) Windows for weeks and never close AC or log off.

I don't think it matters being a small practice or one with 100 users. A patient in a room is a patient in a room. I would never leave the computer open. One, they can get to probably ALL your data as your are a domain admin or, if not, at least info on your computer or even the server if still a work group. Plus, there will be patients who don't mess around with your computer, but wonder about who else does.

I have F7 programmed to lock the computer, which seems like only one less step, but is much easier since I can hold the chart or whatever in one hand and click on F7 with the other.

So, that means you forward it to yourself, and then later have to click on "messages" when you want to retrieve it? Or is there another way?

As an aside, what is completing a note in Epic like vs. AC? The local hospital to our sister site in SoCal (the one that will probably go with NextGen) uses Epic - as does Kaiser - and I heard it's a pain...


Bert, how do you save one chart to be able to go back to it (say the pt. is in the middle of a procedure, and you move on to the next pt.) and then retrieve it? Is the only way to do this to send it to yourself, then go in and retrieve it in the messages box?


The thing is, if we are using a netbook/laptop/tablet, then we are taking that with us from room to room - so having the ability to have two charts open at the same time would be a bit of a timesaver. Having said that, you all do make some very good points about the safety of this (writing in the wrong note). It's easier now with the paper system, because it's simple to tell one pt's chart from another when you have it in your hand - they are clearly different in terms of file thickness, etc. On a desktop, nothing looks different except the pt's name!

Melanie

The staff send charts to my inbox ( ready for exam, needs refill, has a question etc.) When I open a chart if I have started making an entry but am not finished I will forward it to the "Providers" box rather than to my "Inbox". I do this only because it leaves the Inbox less cluttered and it is easier for me to see messages,patient questions and so forth. I keep my messages box open and don't open the schedule very often, I work off of the list in my Inbox. The note is started by the MA when she enters the reason for the visit, Vital Signs and reviews the medication list and allergies.She forwards the chart to my Inbox, I open the chart and complete the note in the patient's room if simple and complete it later if I need to fill the note out more. I don't use AC for billing and don't need to sign the note before the patient goes to check out. I still use a paper charge slip on a Clip-board which they carry up to the front counter. ( The clip board prevents them from folding up the charge slip and putting it in their pocketbook while they leave without paying their bill. Sorry to say, there really are patients who would do this.)
I am also using a tablet and do not leave a computer in the room with an unattended patient.

Melanie

I think you may be making this too hard. I have uploaded some JPGs so that you or anyone may download them. There are eight. Make sure to look closely at some of them as my writing may blend in.

I must say Paint is finally decent in WIN7. Geez

So, maybe this will help. Slide show looks cool, but I don't recommend it.

http://www.box.net/shared/static/69mtj5uu1x.zip