Home Forums Discussions General Discussion New User Support – ACUC and Beyond

I am a brand new user(about 1 mo) and really wish there was some instruction somewhere. I depend on these threads to learn how to use AC. You have helped me purchase hardware, choose software and work interfaces. I hired a new R.N. at the same time we started w/ AC. She and I learn by trial and error. My attempts w/ Wiki topics were unsatisfactory. Yet despite the inadequate training, the program is still so straight forward that I jumped right in and used it full force from the beginning. By the end of the first week, we all agreed that AC was AMAZING. Every day I discover new options. I would prefer if the Help Contents was more detailed. Then you could refer from the Help section to well-defined threads in the support section. It is hard to go to the User Board while I am seeing pts. so every night I would have my list of questions to ask the Board and they always came through. However, if I could have had better answers in the Help section, my day would flow better. I prefer those quick detailed references over watching a video or reading a manual.

Well, I am glad you are getting the hang of it, and that you are finding some help on here. As a lot of people have stated, a manual would be very helpful.

If it helps, there has never been so many posts asking about a manual in the past. I think the main reason is that v5 is a lot more complicated than the other versions, plus there has been a large influx of new users, which is great.

The advantage that the experienced users have is not so much that we know how to use HM, ePrescribe, those (awful) orders, etc. is because we know what we need to get what we have been getting done in the past. In other words, we know what is new to the program and we can ignore it if we wish.

I sort of liken what Jon is doing to what we do as physicians and what attorneys do. While we continue everyday to see whatever patients come in the door, each day brings at least one patient that we have to research for awhile. So, we have to multitask and can't just plow straight ahead. As much as I dislike lawyers, I have always marveled at how they can work on one case while juggling four others. I don't know how they pick and choose what to work on for that day.

My opinion, though, is that Jon (and this is just opinion remember) tends to move to v4 and SQL, v5 and HM/CCHIT, v6 and PM, etc. and doesn't always go back to tinker with things. Adding the things for "meaningful use" and adding practice management are two things that will not only be helpful but will allow AC to have more market share. But, another thing that will also do that, and if not done will lose market share, is a comprehensive manual, help section, etc. When I go to many software sites such as those for backups, EMRs, billing, you name it, they all have very organized websites with very good support areas. Now, I think what one can do is proportional to the size of your company. But, I agree with you completely.

I have thought about writing a manual myself, but there are actually things in v5 that I don't understand; and about the time I finished, v6 would be out.

The other thing, when I look at a lot of my programs such as Acronis and Backup Assist and Microsoft Office, major upgrades from a Version 9 to a Version 10 come out every nine months to a year at best. The updates and upgrades for AC are coming out much quicker now than they used to. At least it seems like it.

Not very original, but I propose Amazing Charts for Dummies.

So to summarize, and at the risk of stating the obvious:
1. Most new users are a bit shy to speak up on this board. I think we all should keep in mind that the new- or trial-user viewpoint is not fully represented here (at least not by those users themselves). On the other hand, as major new features are released, we all become new users in a sense; we are all in it together.

2. There is a significant faction of users who love AC, but don’t like the way it is getting more complex. Leslie eloquently described this viewpoint (“I like simple.”). I am not sure, but I think Wendell advocates a return to V1.25. The fear is that AC will become no different from all of the bloated EMR programs out there. Also, the advancements in AC don’t always match the priorities of the users.
Others find the additional features of V5 to be valuable and find the program to be significantly improved. The Practice Management component projected for V6 is therefore either viewed with skepticism or anxiously awaited, depending on your viewpoint.

3. It does seem that there is a clear consensus that improving new user educational support should be a priority. (David: “I really believe there is a significant underestimation of how complex this program has become among those who have used it for some time as well as the developers”). There may be disagreement about what form the support should take, but it is generally felt to be needed. Even long-time users feel that way, both to make the path easier for those new to the program, and to introduce newer features to the vets. For example, users (new and old) are using the board to figure out how to use the most basic aspects of HM in AC. Also as Indy says: “the next wave of adopters are coming from a very different perspective….They are just wanting it "TO WORK", and don't want to be bothered with the details of how or why.” This will especially be true in the next couple of years as so many skeptical, reluctant physicians are “encouraged” to buy an EMR. The best EMR might be one that will have an “on-off” switch for many of its features, so you can decide for yourself whether to use e-prescribe, HM, practice management, etc.

4. Looking at this, I put potential resource improvements in two groups: those we can do something about, and those we cannot. We can continue to communicate to Jon what we would like his company to do: avoid over-complexity when adding new features; don’t neglect the basics (e.g. the letter writer, spellchecking); and perhaps improve the graphical user interface. Only he and his team can make those changes. We can (and should) ask, but we certainly can’t do it ourselves. At the ACUC, Jon talked about creating an "advisory board" of experienced users to help identify and prioritize proposed changes; sounds like a great idea to me.
There is one educational component that is almost universally mentioned as worthwhile, and that is a printed (online) user manual. Some may rarely or never use it, but almost everyone seems to think it is a good idea. Unfortunately, I put this in the category of “things we can’t do anything about” (until Bert's new blockbuster "AC for Dummies" is published). A manual might be done as a collaboration that involves users, but until Jon is committed, it won’t happen. So despite the potential value of such a project, I put it aside until AC (the company) decides to make it happen. The same goes for a more informative website.
For the moment, I will also put aside the topic of changes in the next ACUC. I started this thread in part because I perceived a bit of a divide between new and experienced users in Providence. It sounds like many others felt the same way, and planning for the next meeting will take that into account. This is basically a topic for another day.

So what can we do something about? Some people have expressed interest in educational videos (the short, practical type: not the ones you fast-forward through). We are working on a few, and would be happy to hear topic suggestions. These will likely take two forms: “beginner” tasks and those addressing newer features. Indy tantalizingly talks about “rich media” (“More on that once I have a test case”).

Left on the list of “what we can do something about” are the forum and the wiki. My experience with the forum is similar to David’s: “I have now been involved in a fair number of threads on this board, and there is a lot of information in them that I am implementing. However, the search function only goes so far....” I would suggest that we seriously look for ways to improve the forum and/or the wiki for this purpose. At the outset I suggested a forum on the board for new users. Valuable “how to” threads could be condensed and moved to that forum. Others have suggested some sort of “sticky” or other way to tag the key, generally valuable posts. Integrating the board and the Wiki was another proposal. Is there some sort of organizational scheme that will allow these threads to be grouped topically or linked together; to reduce redundancy, and become more user friendly? Is there a way to create integration between the board and the Wiki? The forum is a major asset to Jon and his company, and to users; all seem to agree on that. Is there a way to make it even better as the program evolves? Your thoughts...???


"Therefore, since brevity is the soul of wit…
I will be brief."
~William Shakespeare, Hamlet

Oops. Well, I never said I was Shakespeare.

Jon,

Thanks for taking on the task of gathering a myriad of user opinions and so eloquently organizing them.

As always, I do have a few things to say.

First, in answer to Deborah, who stated she was thrilled with v5 and all of its new features, I am happy for her. I don't want Leslie's and my vote for simplicity to mean I/We don't like AC now with v5. I don't think it is so much that I don't like the order module (I don't :)), but I am just not excited about the direction AC is headed. I know there are several forces which are working to push AC forward faster than maybe it should. One was CCHIT and all of the other government acronyms. The other is the rush to get out a PM. Otherwise, and I am not saying he shouldn't do either, I think v5 would have had ePrescribing and a new vaccine application (very well done), with v6 being the version for HM and/or Order module.

I do think it would be extremely helpful if we had a quarterly newsletter with Jon's thoughts about the direction of the company and maybe a PC or DC for Programmer's Corner or Developer's Corner where they talk about what features may be put in (especially those brought up on the board) and those that may be left out (because they simply can't be done logically). For instance, I and one other user asked why the tab function in demographics skips over the M and F radio buttons. According to my programmer, you simply can't tab to radio buttons or at least to those. Just an example.

I strongly feel that Wikis and the user board should not take the place of AC support and actual manuals. Unfortunately, most user boards are like this. While it helps a lot of people, it is kind of like reading. To get the most out of it, you have to be on it a lot. Threads aren't really meant for an archival knowledge base. Forums like Experts-Exchange work great for that, because each question has specific comments one after the other until the problem is solved. Then, it is closed and searchable. There is generally a specific answer that is chosen.

For me, the boards are for two reasons. I like to interact with everyone and try to help when I can. And, I do like the humor and sharing other things. Hijacked threads can be the best ones.

You are correct when you say that the user board is one of the best assets AC has, and Jon should be really appreciative. I know that he is. He has mentioned the ACUG (Amazing Charts User Group) or board before, and it has never come to fruition. Again, no matter who is on it, they will be responsible for picking and choosing what should go to AC HQ. On the other hand, one person could peruse the board and send ideas to Jon. But, I am not sure it completely works that way.

To be honest, I think one of the best things we can do would be for you to copy and past your post and send it to Jon as I think it does sort of give the overall view of the users from one side to the other.

Thanks again. You are an excellent writer. Be careful or you will be co-author of AC for Dummies by Dummies.

Thanks so much to all of you experienced users for listening and helping.

As one small voice in the "simple vs. complex" arena, I would offer the following. We got into the EHR only because we felt it would allow us to do better. Governmental inducements don't mean anything to us. Now, "better" unfortunately comes with more complex; we were already dictating using Dragon and storing in a database, and using electronic prescribing. What will make it better is a program that keeps me from doing stupid things, and that is not here even yet. I want a program that stops me from prescribing metformin for a patient with a creatinine of 2.0. I want a health maintenance program that is simple, complete, and reminds me when vaccinations and tests are due. I want a drug interaction program that does NOT report every possibility found in laboratory animals.

I don't see that those things are going to go hand in hand with the "dictate into a field and call it good" philosophy of early programs including what I used to do, at least until there is some artificial intelligence built in. Do I wish the program were really simple? You betcha... dropping in V5 de novo and attempting to master all its parts was getting hit by a freight train. But, if those things are not there then really; why bother?

Actually, I like V5. I like the overall direction AC has gone, albeit more complex. I think V1 was the basic underpinning of the program and it is remarkably similar.

But the program has grown to where you cannot just "grok" it in a few days. I am just beginning to delve into the HM section, but I think it will be useful and essential in the future environment of medicine. If you skip HM and ePrescribing, V5 is V4. V4 is V3 on SQL. V3 is a fair bit better and more polished thatn V2 (which brought us the import items and I think prescribing in general. V1 was a good charting program.

There has been steady progress. You can use AC like V2 if you like. I always want more.

More will require better learning tools. I agree with Bert there should be someone from AC Central monitoring the boards and reporting back to their team. I know tech support occasionally chimes in but I don't think they actually check it daily or almost so, like I do. I kinda think that should be their job, listening to the customers.

I am more in favor of a monitored (By AC Central) wiki rather than a manual. A manual could be extracted from a wiki in either PDF or &$*^PAPER. (Sorry but isn't the whole point to go paperless.)

I do think that Jon has favored advancement over fixing problems which is an issue, but then again, I am in favor of change so I am very tolerant. I, for one, cannot wait until the PM section is done. Bert is 540 degrees opposite of my opinion. To each his own, but Jon is moving in that direction so I win (NA NA NA NA NA) (Being a Pediatrician has it's priveledges )

Have you forgotten I am a pediatrician also?

-- HM
-- ePrescribing
-- Vaccine methods (migration -- necessary but complicated at first)
-- Orders

So, there are four things that are major differences

Oh I forgot:

-- The complexity of the orders
-- The orders, etc.

LOL

I know I am repeating myself, but I just think it is growing too fast without enough attention to detail. I feel as though it is becoming bloated. Baby steps. To open v5 and fine all of this at one time scares a lot of people.

1/3 of the stuff on the board are things pertaining to fixes such as the letter writer, etc. I think those have to be looked at or the trail of buggy pieces will get bigger and bigger.

Once again, my opinion. And, Travis' and Leslie's (I think).

Wendell - I am an FP but I was also partial to neaner, neaner, neaner (LOL)

Actually I think the orders are a good start compared to in the past where you had to make all of your own templates - it is nice now that they are alphabetized and categorized. Actually writing an order is pretty easy and makes a more standardized approach - in years past I noted things like:

UA
Urinalysis
urinalysis
UA with C&S
UA with culture
ua with culture

All of the above occurred in my office depending on who wrote the order. It is slowly getting to where now it says Urinalysis with C&S if indicated. This has helped my documentation look better and make it easier for my staff to do an order at my request.

I would also love to see the letter writer fixed, but often the fixes that people want are not really fixes .... many people want to edit a letter once done, but dictation was always like this, if you didn't like it after typed you crossed out, redictated or lived with it. Yes I would love fancy fonts, more editing features, etc but I really think other features in AC have been more important and I hope Jon will find time to get it working better.

Just my opinion..... hope no one gets mad or offended.

Steven,

I think I am misunderstanding. How does the order section keep you from making templates. Isn't entering U/A for an order a template.

You can tell you are a family practioner since you write for U/A reflexes. If the ED orders that, we get so frustrated...AARRGGHH. I would be curious to know what Wendell thinks about that.

I am talking about the two year old that gets put through a cathed urine and a fever to 103, and they throw the urine away without culturing it, because there was no leukocyte esterase. Sometimes, they don't even do a U/A micro.

And everyone knows that a Urinalysis is for a lot of urine and a urinalysis is for a little bit of urine, lol.

You can make templates in the current order section - one of the other people here has numbered some so they are near the top. I just find having a nicely alphabetized list of lab orders so I can go through and check the diagnsoses I want and then multiple different labs makes it more standardized than using the old Version 4.

I guess the dilemma with UA's for instance is that when we are busy it is difficult for the lab to do microscopic UA and then fax to me to wait to decide if I want culture. For adult medicine this works pretty effectively - certainly for some I order Urinalysis with Culture and Sensitivity regardless (caths, etc), but for plain everyday UA's for adult pts the above works fairly well.

I think the good thing about orders is that with the new system there is standardized orders - it is really nice for x-rays and MRI's particularly if someone is gung ho enough to put in CPT codes (I wasn't). It does make your chart look better, I think. But whatever floats your boat (LOL) -- I just think the order writer is not that bad (have used for several months).

Hello from souther WV. I really enjoyed the conference and learned a lot, and came away with a lot of how to confusion. We are one of the offices that have 25-30 computers and AC keeps dropping off. We are working with tech support to go the larger server route. Until then we can not go all electronic...but I am diligently working toward most everything electronic. I need your help. There were a lot of how to options talked about at the conference but I dont know how to go about them. The paper work and chart chases are more than ridiculous so I really see the need for electronic. How do we set up to do e-faxing? We probably get 500+ faxes a day. Is there a way, or program to set up so that faxed reports go into patients chart, like the labs do? Or do they come to a central location and someone puts in patient chart. Then how do we know reports are new and in chart for review? I started with version 5 in Jan. and glad I did so I cant compare it to others...would just add to the confusion. I want the office to run and flow seemlessly electronically..I looked at Phressia checkin while there and it looks good. A lot of things look good but in your alls experience what really works and makes life easier, do you need all these fancy addons, which increases stuff you gotta know about and more stuff to break down? I want the experience of the ages to tell me what works. I am not a tech guru but am embracing it and want to learn and want things to be smooth. So I started with AC have labcorp on board dumping into patient charts. How do I fix faxes? Will stop here and take one step at a time. Did buy I-pad and do logmeon. It is not practical for seeing patients but good if out of office and you need quick info. Games are fun. Thanks for all your help. Jana Peters D.O.

Hi All,

I would consider myself a relatively new user. We started gradually adding AC functionality since Jan 2010 (Starting w/the scheduler, then notes, then orders/medications).

We would LOVE to have a user manual. For us, it's workflows workflows workflows. We have awkwardly been adding on each AC feature but haven't quite worked out the workflows.

We attended the ACUC and our favorite part, perhaps, was the demos on how each doctor uses AC in their practice. I would have liked to see much more of this, and broken down into much more categories.

We saw workflows for:
(1) Electronic Faxes
(2) Documenting an Encounter

We would LOVE to see demo workflows of writing/tracking orders (w/and w/out AC), doing advanced/customized HM, and ELECTRONIC LABS.

Yes, the final piece we have yet to implement is a workflow for labs. We see how some people are skipping the whole electronic-importing-interface thing and just using the faxes that come in but we would like to have the information in our database for running searches.

We would love to see a workflow for how people sign off and document notes about incoming electronic labs. It seems a bit cumbersome for us, and not being able to open the patient chart while viewing a lab is a huge disadvantage for us.

In short for future ACUC's or tutorial materials in general, we would like to see more information on workflows:
(1) Orders (Writing and Tracking)
(2) Electronic Labs
(3) Documenting Encounters (especially those addressing more than one problem since we see patients for at least an hour and can discuss between 4-12 different health issues in one visit)
(4) Searching the chart to piece together the history of several problems over time (ex. reading through old encounter notes, etc.)
(5) Documenting other notes/messages
(6) Using HM (Basic and Advanced/Custom)
(7) Using other additional features (ex. Alerts/Directives, Addendums, Miscellaneous fields, etc.)

And not just one workflow but several. Since several different offices have adapted several different ways to do the same thing, we would love to see some kind of demo of all the different ways people have adapted AC to all these different workflows. That way, we could look at all the different ways it could be done, and pick which one we think would work best for our office.

We would have liked an on-site trainer to come to our location but there's obviously significant cost issues with that. In short, having a manual is a must, and also to have demos (videos or short mini-manuals) on all the different ways to implement a workflow: Orders, Labs, Encounters, Other Notes, HM, Miscellaneous features, etc.

All in all, we were very happy with the ACUC, we got a lot of great ideas and tips, but we are still struggling with making it work smoothly for our office (Right now it's still a little awkward).

We are looking forward to seeing more documentation/videos, etc.

- Sam K

Jana,

As far as faxes go, I would do a search on faxes as there are at least 30 threads on it.

There are a few ways to do these. You can go with the Internet Fax Providers such as Ring Central. It handles incoming and outgoing. I used to use them, but they were pricey and not as reliable as I would have liked.

You can use a modem on one of your computers and use a program called Snappy Fax. It works rather well.

We use a fax server. You can do this with an external modem/server or an internal fax card or fax board. We have used both. It essentially handles all faxes, although we have a walk up fax as well, which you would need.

Most users (and we still do this to an extent) use a multi-function printer such as Muratec, Xerox, Toshiba or Brother. A lot go with Brother as they are good and inexpensive. I don't like them as they only allow importing as tiff files. But, that isn't always bad.

Muratec (from France) is the next level of cost. It will do all MFP such as copy, scan, print fax. It is networkable as is the Brother (sort of) and can Fax to PC and do PC to fax and it does it well. So, most of the above will allow PDFs or some format to come to one folder on your server

@Steven I was joking about the U/A reflex. That is pretty much standard in adult medicine, which is why the ER docs continue to order them on 6 month olds. But, infants and children don't tend to localize their infection as well as far as inflammatory cells. I don't generally do a urine test on a girl over 14. If an 18 year old has a U/A that is wrong, oh well. I agree doing a U/A, then looking at it would be crazy. We do TSH reflexes all the time.

As for the orders, I guess you will have to write a book and spell out to me the difference. We could do ICD-9 code, alphabetical templates, etc. with the older (and much simpler) method. I just don't see what was wrong with before. But, supposedly Jon is supposed to make it better some time soon.

This new user (2 mos or so) has found that the learning curve isn't too steep and this User Board as well as the various items on Wiki go a long way to filling in the blank spaces. By initially maintaining paper and EMR charts simultaneously the learning curve for me and the office staff hasn't ended at the edge of a cliff i.e. not "Tomorrow it's all electronic do or die". So, since AC is quite malleable we've gradually put together the pieces that I need for my specialty (allergy). Next week all new patients will be AC only.

I would appreciate any thoughts on one remaining anticipated logistics problem which is.....

The problem is walking into an exam room "cold". With paper charts I glance at the last visit, previous skin test results etc. and entering the room start a conversation with "How're you doing with grass pollen season?" or something clever like that. With EMR the chart is sitting on the desk, so to speak, and I would have to open up the patient's record on the screen before tailoring my greeting/approach to the patient's specific problem. Yeah, the personal touch. One could carry a handheld and bring up their record or scout it out on a main computer just before the encounter but this seems a bit time consuming.

Well, Ches, that's easy I think. I believe I am as close to paperless as can be, but I still have to use paper somehow. I guess there are three solutions.

The first is what we do. We still use paper Encounter forms or Superbills. We have clipboards, and we have the encounter form on the clipboard. On that we have the, obviously, the patient name, DOB, and reason for visit. You could ask your staff to put as little or as much as you want. All of these things are on the sheet when printed. So, at least when I go in the room, I know who the patient is and the family, and I know the chief complaint. This also makes it easier for me to start asking questions (although I risk not knowing some data my MA put in the chart). But, I am then not immediately opening the computer and chart.

Another way that you could use +/- the above would be for your staff to print the last visit. This would give you a lot of information to go by. Depending on how large your notes are, you could even print them on the back of the Superbill, but I am guessing, being a specialist, they would be longer. It would make you look awfully smart if you quickly glanced over the note and then tucked it under the Superbill. You would be able to talk about the pollen and a few details of their last visit.

Finally, I know that Jim who put on the ACUC, likes to print off the summary sheet and give it to the patient to look over and make sure everything is correct. You could do this as well, but it wouldn't contain the last note, but it would have the list of diagnoses, which I would thing would be less helpful with a specialist.

I guess don't miss the forrest for the trees by trying to get rid of all paper.

Just helped a practice move to UpDox, and they are very pleased with their ability to take a fax, import it to a specific patient through the integrated patient look-up, and also put a message in the practitioner's inbox for the chart sign-off in one step. Working on implementing the patient portal (included in UpDox) so that the lab results can be sent to patient as well. [Save time/money on sending out]

Hi Sam,

I also enjoyed the segment that demonstrated how four docs with varied backgrounds used AC in their practices. At the first ACUC I remember telling Jon that it took me approximately two months until I began to be reasonably confident, but I think that I would have been there in a couple of hours if I had had the enlightened me there to mentor me. However; having Bert, Brian, Wendell, Martin the others on the User Board was the next best thing.
My point is that a mentor, if you have one nearby, would be invaluable.

Jim

What I do is to go to the main screen and see who the next patient chart is. If you click on the name you see the CC and part of the HPI (which my MA's start to fill out.) This will then give you a brief intro you may need.

If I need more I will fully open the chart but not delete it (would you like to remove this from your mailbox? (or something like that) ) and then I have all the info I need to go to the next patient.

Running the risk of being that annoying guy who just won’t let go….

Before this thread “went cold”, a new user asked about faxes and then another asked about templates. They got some advice that I suspect proved to be useful. It was also suggested to “search the forum for faxes; there are probably about 30 threads about that”. Actually, “faxes” returns over 100 responses. “Templates” yields the same. I guess the search function maxes out at 100. No way to tell exactly how many threads those represent, since one of the minor annoying features of the search function is that it doesn’t list threads, just individual posts.
Anyway, my point is that this is not a very productive way for new users to get their information. As of now, there are about 23,000 posts on the forum. This is totally a guess, but maybe 2% of those, or 460, contain information that new users would want to see again and again. If the sentiment is against a separate forum for new users, isn’t there some way to have those posts tagged so they are visible at a glance? Or even grouped, so that they all appear in one area? That way, new users looking to learn about faxes, templates, etc. could find them much more quickly.

At ACUC I suggested that established users volunteer to be "mentors" for new users...make ourselves available for questions by new users. Contact information is in the user's profile. I sure would have loved someone to talk to when I was first starting out. I agree that searching the threads does not produce much AHA! response although sometimes the answer is there, many times not very efficiently so. The gaurdian angels tech support is sometimes a good source.

Deborah, please don't take this the wrong way. But, don't we already have established users that volunteer to be mentors for new users.

While it is generally established uses helping new users, it works the other way around as well.

I don't think I have seen question on this board go unanswered, usually by two or three people in the seven years I have been on it.

Well, I think that new users might be reluctant to post questions ( looking dumb in public). I don't even know how to start a new post and I've been using the board for more than a year. If I were a new user looking for a mentor where would I find that list? Could I call someone to ask a question? Where is their number? How do I volunteer to be a mentor? ( Or am I not expert enough?)

I do believe newe users are reluctant, but then even old users. I don't start new threads all that often and often have to fumble to find how to do it.

You can go to topic options and select new topic (actually in the past I went to the "base" page for the section and there is a tab called new topic. Learned something new.

I'm not sure how to volunteer. Sometimes it is just answering a question that pops up and taking it from there. I do not know how AC Central knows who is willing to mentor, although I do know they tagged Bert and me.

I do like the idea of culling the best from the Board. I think they are working on the best ideas from the ACUC. These could be done in tandem. Lot of work, though

Well, maybe not all new users are reluctant. We were new users, and figured "what the heck", so we've posted lots. The main point is that we were courteously received. Had we been treated as annoyances and interlopers into the old boy's club, we would have dumped the forum and maybe AC to boot.

Even though we are not "seasoned" users, we have muddled through a lot of issues that I try to keep in mind when questions from new users crop up so I can point to a recent thread. I think it is important to continue to encourage new users to post as much as possible so this doesn't turn into a board filled only with arcane discussions and fine points.

1. This is probably the best and most informative forum for EMRs that exists. New users should probably note that new users post here, and they should feel pretty welcome about posting without looking bad. If they do, I feel bad for them.

2. How to start a new post? Ask the question. Wendell or someone will answer it within minutes.

3. The list is a good idea. I started making a list just trying to figure out the logistics of it.

4. My name (indirectly), my phone number and email address are in my profile. I have tried repeatedly to get people to put their email address in their profile, but it is a losing battle. Only three of the top 10 posters have their emails listed in their profile. Not getting into the merit of it, but if people don't want to be contacted, then that makes things tough.

5. I have never minded taking calls from prospective users, but I think that most would not want to take calls out of the blue. I always think it is interesting to put thing in perspective. I Googled 10 people on here, and nine came back showing the name, practice, address and phone number, so that information is already out there.

I don't want to be the devil's advocate here. I guess the combination of v5 being more challenging and the ACUC still in the rearview mirror, has brought the issue of access of information to the forefront. I think it is always a good idea to continue to try to improve things, but the board has always been very helpful just that way it is, and I don't want to discourage people from using it the way we always have. Questions, answers, comments and fun.

Bert,
1. I agree entirely that this forum is probably the best one on EMR's in existence. Hopefully you view my suggestions as an attempt to make a great thing greater.

2. As welcoming and supportive as it is, I do believe that shyness or uncertainty how best to use the forum sometimes inhibits new users.

3. If I interpret your #3 above appropriately, a discussion of the logistics of making a "list" are just what I have been suggesting. If you want to discuss this or get some help from the group, feel free to say so.

4. At your suggestion, I will add my email address to my profile. All spam I receive as a result will be forwarded to you. :-)

5. "Questions, answers, comments and fun"....who could argue with that?

No better EMR user board in the WWW. No doubt.

"Sticky's" at the top of each forum for the most common issues may be good. Maybe just 3 or so from each forum.

Agree with Jon that the search function is irritating because it pulls up every single post instead of the thread. So if one topic had 100 posts, that's the only thread you would get out of your search and it may not have what you need.

If this user forum is the most important way to learn AC, it needs to be the best functioning forum on the planet. Search the forums, find the threads, then when you click on the post, it should highlight your search terms. I'm sure that's a major overhaul on the search function though.

That being said, I have no fear of posting something that's been posted before if I couldn't find it. I have never, and will never, tell someone that they should just do a search as I know the search functions is sub-par for finding direct answers. I'll either answer them if I know the answer or post a link to the thread if it discusses it elsewhere and I remember talking about it.

Still, a user guide is most important to answer all the basic stuff. Forums for the little odd quirks and work-arounds are great.

BTW, without Bert on these forums, this forum is just average. His time, energy and expertise are unrivaled on any forum.

Good point. I would be interested in knowing a better way to change that. On one hand, having a separate area may decrease anxiety, but some can take it as condescending and not know where to post. The main problem lies in the fact that a) new user posts in new user area, b) Travis answers them correctly, c) Bert seeing an interesting thread, adds his two cents (as always), d) Leslie chimes in with something helpful. Now you have an "expert" thread in a new user area.

But, maybe there are other ways.

It would be easy to make an Excel sheet (I did) with areas for names, phone numbers, emails, etc. Remember, before anyone gets all excited about entering his or her phone number, your office phone number is everywhere including one click away on Google. Having said that it is probably the worst way for initial contact, and some may not want to encourage being contacted that way. If I uploaded the document and it wasn't read only, that would be problematic. I would almost have to enter the data myself. Basically, name and email would be enough.

I know you are joking, but just want to make sure that everyone knows how to put emails on message boards. First, you should be aware that you have to enter your email anyway, and it is already in your profile. I am not sure how "botable" it is. But, when you put an email anywhere online that is not in a form, you should always put it in a format such as user AT amazingcharts DOT com or user@amazingcharts.com_removespam. The bots cannot harvest these, and generally leaving out the @ sign is a good idea.

I'll have to think about that. This goes back a year or so ago, but Jon changed the board by adding "The Most Recent Posts," bar on the left. Before that, one had to go through each forum and search for discussions they wanted to read or comment on. It was easy as it is now to forget to select the option to be notified. Now, if you forget, you will probably see it again on the left. Since that left hand column has been added, I look only at it. I put up a sticky once three months ago, and it got to replies and very few views. But, I can look at that again.

I can't agree more with the two of you on this one. I will ask Jon about it. When I think of Experts-Exchange, when you search, you get an entire question/thread, not just the one comment. Now, it may be that the comment was what brought up the thread. Contrary to what everyone may believe, I don't have full admin powers on the board, so if it is possible to change the search features, I haven't found a way. Jon would probably have to do that.

I do the same as Travis. I never tell someone to search for it. Actually, even in Experts-Exchange, which is an award-winning site for IT information and help thousands of experts, I have never gotten that either. Of course, they all want the points. I do search there first (their search is incredibly good), but there is nothing like an answer that is completely tailored to your specific situation.

Agreed, that an admin guides, an quick user guide, FAQ, Knowledgebase, etc. complimented by the board would ideal.

Thanks, Travis, for the compliment.

Looks like I misunderstood; I thought you were looking at the logistics of creating a "list" of key posts to index/catalog/tag.

I am all for that, but it sounds like a huge project. I suppose one could find all of the threads that pertain to my favorite MFP, the Brother :), then put the URLs in one post.

Bert, I wonder if maybe it is not such a huge project.

For starters, it is going to be aimed at new users. That means nothing that pre-dates version 5 needs to be considered. Then I think you can focus on a few of the forums, like tips and tricks and general discussion, and then go for the thread title. Granted, a lot of "meat" is found within a thread that meanders around, but in lieu of a manual some "meta links" to topics like e-prescribing, letters, health maintenance, imports, backups, and the like might go a long way.

Good idea. I'll take a look at it.

I still think new users are going to get lost....it can be too intimidating. AC will loose( potential)users and we all have a vested intest in AC growing and surviving. The next wave of folks dragging their feet about getting in to EMR need more help jumping off the board into the deep water.
They need access to some people who can answer simple questions, get them pointed in the right direction, a mentor.

I am willing to do all of the above, but we are just going to have to agree to disagree.

I did my part again tonight; spent over an hour on the phone with a prospective buyer. Yes, I guess if they saw a list on here, they could email or call.

I don't see how AC is intimidating at all. Sure, v5 is a little more difficult than v4. I am really past the point of its being our responsibility of what should be AC's job. User guides, FAQ, KB, etc. on an organized website. But, instead they plow ahead with Practice Management before getting the regular AC set up with proper support. The person I talked with was told by support he would need 160GB hard drives on his computers. Why would that be?

OK, so a lot of doctors are computer illiterate. But, that is by choice. I just have a few questions:

Everyone of these people who are thinking of purchasing an EMR and need a mentor, went to high school and got a 3.5GPA and high SAT scores, went to college and got a 3.5 or better and smoked the MCAT. They learned how to write an essay and how to interview. They/We traveled to over 12 medical schools to get in where they somehow got through two tortuous years of memorization and then a 3rd year clerkship from hell. Finally, an easy 4th year. Then they learned how to match to a residency and how to manage patients with no sleep and 80 hour weeks.

I guess you could say they had residents and attendings as mentors. I just don't see how difficult it is to decide to get an EMR and learn how to use it.

Again, agree to disagree.

Bert - sounds like the advent of the third wave/phase Docs.

I do wonder what was this Doc's priorities? Goals in implementing an EHR?

I think this all sounds well and good -- BUT people cannot remain on topic, almost every title loses focus and gets about something else. If you really want to look up faxing then the fax topic needs to stay on that and not change to how to enter vaccinations, etc. I also think people need to make their own choices and Version 5 if you never did any Version 4 should not be that hard. The basics of using AC take virtually a couple of days of playing with it to learn (if you have basic computer knowledge) and I don't think any thing can help you on any UB or using a manual if you can barely turn on the computer - for that you need to take some computer education.

@Indy Good question. What I liked about him (and this may sound crazy), but he let me talk with him for an hour. Most start to think within five minutes, "What the hell have I gotten myself into?" and they are ready to hang up.

@Steven Very well said. Couldn't agree more.

And, I hope I am not being insensitive to Deborah. I think she knows I love to mentor. I just want to do it, because I want to. I think we all kind of give Jon a pass on more support, and we see all of this terrific information on the UB from a bunch of great people; and we wish we could bundle it up or bind it into a book. But, as Steven is saying, it's as if Chapter 4 comes before Chapter 2 which comes after Chapter 9.

There is no question that saying you "do your part" is a gross underestimation. What you do is miles beyond what anyone would expect. The same is true for others on this board. It is also true that there is a support role for the company and a support role for the user board, and the former is lacking. But Bert, we can't make Jon do what he does not want to do. We have to accept that. I would suggest that you can help fill that gap by enhancing the utility of the forum. Please, continue what you do for the good of all, but please keep your mind open to additional approaches.

Here is the crux of the issue. Bert, sincerely, with all due respect...your statement is irrelevant. What matters is how the program appears to new and potential users. In my opinion, docs as a group are getting more and more computer literate. Yet if you talk to the great majority, those who don't use an EMR, you will generally hear that they are petrified of the prospect. Compared to other EMR's, yes, AC is much more accessible. But to most docs, any fundamental change to their practice is going to be intimidating, at the very least. AC is no exception.

One of the things I like about Steven's posts is that they are pithy and to the point (yes, I am a bit jealous). This also leaves some room to interpret as you like. So we both agree with him; I think he is saying that because posts are so long and meandering, we need a better way to catalog or document them, to keep them useful. (Unless people suddenly change their ways and "start a new thread").