At the end of each day, I usually have 10 or 15 charts left to complete that I have forwarded to myself. I go to my messages, pull up a chart and finish the note. I then click on the Sign Chart button, pick the icd-9 code and save the encounter. Then the Print Encounter box pops up. I like to print hard copies of the each note for backup. However, the "select encounter" list has "1stEncounter" as the only item in the pick list, even if the patient has multiple previous encounters. Hitting the print button gives an error message and nothing is printed. The only work around is to close out the chart, again pull up the chart from the patient list (if I can remember the name of the patient I was writing on) and print from there using the "file -- print" selection at the top of the screen. This adds time to each note which adds up if I have a lot of notes to complete, and definitely doesn't get me "home for supper". Sometimes the problem is corrected by shutting down "Amazing" Charts and restarting, but sometimes not.
That is very odd. I have never encountered that problem. At first, I was thinking the chart was being forwarded to one database and then being brought up from another except you say you can "finish" the note. It may be a bug, but I would make sure every Amazing Charts is using the same database.
It would be helpful to see some print screen shots. You can send them to my email address in my profile if you don't figure it out. Or give more details. Good luck.
I had this problem with one of the early 3.6 betas and it would occur very frequently (every 1-2 charts). The updates seemed to resolve it, but it recently cropped up a couple of times last week. I did not taken the time to trouble shoot it. Some of my versions in the rooms go back to 3.6.15 up to the latest 3.6.19 and there may be some kind of mis-match.
All you have to do is close the print box, then re-request to print from the AC desktop and all the visits are there again. Annoying but not a major issue
Wendell Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
Wendell, thanks for solving the problem -- it sounds like a bug -- well it is a bug. One I haven't experienced probably because I don't print out any notes.
But, this brings up two points:
1) Although, I don't print; from what you and John are saying, I agree with John, that it is an Amazing Annoyance. That would drive me crazy. Plus, it depends on how your patients are put in. With most offices, the MAs enter the patient data in the room, so that the chart is in your inbox, but the name of the patient is also right there in the Patient List. So not too hard to print a note from there, but still ridiculous to have to do. We have a triage area so the MAs enter the data on a different computer and forward the chart so that would me having to find the patient first.
Again, this is a bug. And, bugs need to be fixed. I would call support, email support and email Jon. This isn't about support as much as alerting Jon about a bug he may not even know about that can be easily fixed in the next version.
The other thing Wendell touched on was the fact of different versions on different computers. I used to update all my computers with a new version, but new versions have been coming out so fast and furiously, that I can't keep up, so I just update my office PC. The features aren't helpful enough yet to warrant putting them on each PC. The website or manual, whatever, does recommend installing the program on each PC and browing to the database. Sometimes, I think it owuld be easier to just install one copy on the server or designated server on a peer-to-peer and making shortcuts to all the computers. Then, you would only have to install new versions on one computer. I would think that having the full version on the workstations would give you some advantages such as performance, but I have run it the other way, and I haven't noticed any decrease in speed or function. <G>
Hey, I too have this problem all the darned time. If I am signing a bunch of charts at the end of the day when i get the print encoutner window sometimes I get "1st Encounter" and nothing else. Once that bug pops up in one chart all subsequent charts do the same when I sign them. The only way to "fix it" is to exit amazing charts and wait a few seconds and start it all over agin. I reported it once or twice using th bug reporting feature in AC. I'm still using 3.6.9
Alberto Santos III, DO Southwest Family Medicine San Marcos, TX
I have noted that there are bugs that are very odd (can't recall any at the moment) when I used to have the workstations updated at random. I started doing a sequence of updating the server first, then the workstations and all of them if possible, in that order and that seems to minimize the bugs. I don't know why this is, it may be the way the information is pulled from each version on the workstation may cause subtle differences in data and confusing the program. Sounds simple enough. I also found that running AC from a server is less problematic than peer to peer. But what do I know.
I think you know a lot, actually. And, in general, having a central server is generally better than a peer-to-peer as permissions are much easier and no one is actually using the server. Just have the user on the PC with the AC databases have to reboot, and well, there you go.
I have thought through this a number of times (yes, Bert get a life), but from my perspective and I could be wrong, but the program on the server shouldn't matter unless databases are updated as the ACs on the workstations have increased functionality of the upgrade but only send and pull information from the databases are on the server. It is noteworthy that the databases must be in the AC folder to function as databases.
This lstEncounter is an annoying bug that we've been unable to replicate (we need to have a way to replicate a bug to solve a bug).
It comes and goes, and I believe it has to do with the speed at which the database is updated on the client's computer. The note, when saved, is written to the AmazingCharts.mdb and the table gets updated. For some reason, the print window is repainted before the database is adequately updated - either due to network traffic slowing something down, or due to RAM, or other issue on the server (This is just a theory.)
If anybody can consistently replicate the problem, please ping us at www.amazingcharts.com/help so we can replicate it. If we can, we can solve it. (True for any bug.)
That said, we've begun development on a SQL Express version which may solve the issue as well.
Jonathan Bertman, MD, FAAFP President Amazing Charts
Bert, For those of us not knowledgeable about SQL, can you provide us with a "SQL for dummies" information site. I understand that SQL will provide lightening fast access to the database and can handle more than Access. Outside of that, I know very little about SQL. Sounds like this might be a big upgrade.
My hope is that when you switch to SQL Express, your team will rework and normalize the database. I can tell you many issues that it would fix in the application.
Well, I certainly don't claim to be a SQL Server guru. Basically, all databases from Access to Oracle use structured query language as their "language." Oracles and SQL Server (especially Enterprise) are considered in the upper echelon.
SQL Server Express is Microsoft's free version of SQL Server 2005 which, Roy, you should already own.
As you stated it simply has much more performance, security and functionality depending on how the application interacts with it. It sounds like Jon is actually going to make two versions. Backups can be significantly more difficult with SQL.
Yes, it should be able to work with peer-to-peer as easily as on a server-based model.
I haven't found too many good sites that talk strictly about SQL Server as it relates to Access, etc. They all seem to delve into the science of databases and how to build them as well as relational databases and the like. It is probably just as easy to go to Microsoft's site and read or watch the videos, but they tend to be rather technical.
My preference would have been MySQL, for a number of reasons, but once incorporated in a commercial application (like Amazing Charts), they require a royalty payment.
One advantage, at least to me, is that the server runs on Windows, Linux, or BSD. In my office ALL of our servers are Linux based, and running Microsoft's SQL engine means having to trust a <shudder> Microsoft server in my office. <sigh> Even so, it's LIGHTYEARS ahead of the current Microsoft Jet database engine we're on now.
While I haven't discussed this with Jon, my thinking is that this will be able to run either client/server or shared file. We'll see.
V.
Vincent Meyer, MD Meyer, Malin and Associates, PLLC
Yes, please for those of us not ready to make the server leep of faith yet, please do what is needed to maintain P2P. If back-ups are an issue then perhaps it's finally time for my back suggestion from a long time ago??? A button like a disk, that allows us to back up AC in a format the AC likes best that we can assign to "ANY" source like various drives as well as off-site back-up and then a restore utility that can restore any back-up to anywhere you direct it. Much like many of us do all the time with our QuickBooks. They really have it down pat it seems. And from what I've seen of the Altapoint Lit so do they for that matter, although I've yet to play with theirs... Thanks for listening Vinny.... Paul
"Beware of the Medical Industrial Complex" "The Insurance Industry is a Legalized CARTEL"
I prefer MySQL too. Sometimes, open source scares me a little, but generally it improves things much faster.
Paul, I doubt that Vinny and Jon would set up something where you would have to have a client/server setup or he would possibly lose 75% of his business or whatever amount is peer to peer. I think Jon alluded to in his post that there would be two versions, one with SQL and one with Access so that would leave options open.
So does that mean if I want the benefits of a SQL style database I'll have to go full blown server then??? As in my email to you, I am looking into a VPN type thing, like a VPN router to allow safe tunneling between outsiders, like a new billing person and our data here in the office. If I'm not mistaken, when going server, most of the MS server software comes ready with what you need for VPN's, meaning no need for a VPN style router, or am I missing something here??? Not that up on this stuff and that is just my point.
I don't want to crash or significantly slow down my office during a (mine) steep learing curve period. But perhaps that is unavoidable. But then that defeats the entire idea of a simple product like AC that most average intelligent, non-geeks can use and maitain on a day to day basis for themselves, right? The whole concept of this model is that we small guys who can't afford half an IT team in our offices, can still have most of the benefits of an EMR system. Once I need expensive licenses for mutiple users on the server OS, servers, network and IT people to set-up and maintain it all, then the whole model really starts to fall apart. Now we could be with any number of the other products, that all have these same expensive rereq. requirements, right?
Our last EMR was a SQl based thing, and they used to get mad at us for not being silicon valley geeks who could keep up with all the terms that they threw around. Like being a geek was the enterance price of admission. No less that, that was never stated while they were romancing us to drop big money on their product.
Kind of makes me sad and worried.....
"Beware of the Medical Industrial Complex" "The Insurance Industry is a Legalized CARTEL"
From what I understand, you could run SQL on the peer to peer. SBS 2003 does have VPN working with Remote Web Workplace, which is all you would need anyway.
If you purchased a server $2,000 basically, maybe a bit more, you would then purchase SBS 2003 Standard or Premium $500 then 5 CALs $350 if you had more than 5 PCs including the server. Otherwise, you don't really need anymore CALS except for antivirus, if you want server centric AV. SBS 2003 has pretty good NTBackup, although some 3rd party ones are better. BackupAssist $200.
It can get a bit pricey but the functionality and security are well worth it.
But, I still would check out LogMeIn www.logmein.com Hard to beat. Very good and FREE.
I use LogMeIn as well. I think I learned about it from Joseph. It's great because I can log in when I'm on call and pull a chart, complete my documentation and be done with it. There is a bit of delay, and the screen gets scrunched down (I use large screens at home and in the office), but all in all...no complaints on LogMeIn.
And as Bert says...it's free
Barbara C. Phillips, NP Beachwater Health Associates Olympia, WA
