Home Forums Discussions General Discussion Final Development Poll

This poll merges all of the polls along with the latest suggestions. There will always be a list at the top of the suggestions for AC.

At first, this will look redundant before you vote with the choices listed in the poll. But, after you vote, you will no longer be able to see the statements in the poll (very well) only the results. So, I have listed the original choices as a reference.

You will get 20 votes. You may continue to list suggestions below the poll. These will be looked at but will not be entered into any further polls. At least not be me.

While the votes from Poll 2 are no longer included in the latest poll, the top 10 were placed at the top even though the first received only one vote. (Inside joke)

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1. Imported Items Folders Stay Closed

2. Tracking labs/imaging/consults more efficiently.

3. Word for letter writer and save in letter writer.

4. Multiple charts open at once.

5. Impossible to lose note. Smoother way to close note.

6. Ability to add practice logo.

7. Auto refresh messages with visual or audio alert.

8. Adding pharmacy phone numbers.

9. Increase abilities with email from demographic, e.g. export to Outlook or make distribution list. Exclude disabled patients.

10. Rich text.

11. Improved spell check with spell check saved on main pc and not on individual client.

12. Choose own categories for imported items.

13. Improve med and ICD-9 list.

14. Ability to change the section titles.

15. Add old vitals to growth curves.

16. Export/import Rolodex and ability to always save.

17. Both parents on demographics.

18. Ability to edit the insurance list or other drop down lists.

19. Better time tracking of patients either when arrival or in room.

20. Ability to write more comments on scheduler that show up when printed.

21. NPI and EIN in receipt note.

22. Ability to remove multiple templates.

23. Superbill before completed chart.

24. Ability to edit completed chart with way to know it was done after the completed chart.

25. Select printer rather than Preview Print.

26. Ability to hide/delete actual worded diagnosis when using ICD-9 code.

27. If vaccine Given Elsewhere, allow date to be "today."

28. The reason for inactivating a drug window should be a preference. > 80% of my inactivations are obvious, e.g. antibiotics. This should self-inactivate anyway after ten days anyway.

29. Setting up labs should allow for comments but also for templates of associated labs that have no restriction on characters.

30. Can reply to a message and send it back to person who sent it AND save it to chart with your reply attached.

31. Do not auto delete deleted files when AC is restarted. This should be a manual process.

32. Obstetrical record

33. Ability to open last note from Print Note Window.

34. Improved process to print entire chart including imported items.

35. Interface for Dymo Printer.

36. Ability to enter lab data as discrete data - e.g. glucose, UA, PT/INR, chemistries, for in office labs that don't have interfaces. Would allow you to use data and tracked data is not overly useful.

37. Inexpensive signature pad for front desk to sign in and sign HIPAA paperwork.

38. Addendum with vitals so could do bp check, wt. check, etc. without showing as visit so you can still quickly highlight name and see when really last seen.

39. User's manual preferably a downloadable PDF that also covers best way to install server and clients when upgrading.

40. Ability to merge patients.

41. When opening an imported HL7 lab report a button to open chart.

42. Merge imported items.

43. When scanning items be able to scan multiple sheets i.e. 2 lab reports - 1. Patient demo sheet -1. Insurance information sheet then be able to sort them into their correct categories.

44. Everything and anything that has to do with the orders' section.

45. Drag and drop OUT of Imported Items.

46. Nested folders.

47. Button on Imported Items page to open HM.

48. Button on I.I. to send staff message, like in v4.

49. Tabs to categorize and alphabetize labs, x-rays, referrals, etc.

50. Would also like to be able to put clinic group names, as well as doctor names in Rolodex and Rolodex by specialty.

51. Allow elective signing/locking of the chart.

52. Allow multiple staff members with appropriate security access to the chart without having to forward it back and forth.

53. Add icons to increase room in the available fields ? icons are intuitive and gives more screen space for encounter fields. Change the upper large buttons to smaller ones or icons.

54. Consider having the encounter fields small, but allowing them to expand as they are filled (so, for example, Assessment, if long, will not need to be scrolled through).

55. Reformat the allergy field. Too much verbiage. Allergies only. No need for who updated when. Use a regular black font unless there is an allergy.

56. Allow Users to populate their own Rx Sigs in the drop down list in ?SIG:? instead of just allowing stock ones in the drop down list.

57. Add a 4th button on left that allows you to see the actual entire contents of all chronological Encounters and Messages in the right field.

58. Reduce the massive gray 1/3 left side of screen, which will allow you to make the print in the past encounters fields larger and more readable.

59. Eliminate physical Exam: wt. Height? if field is not populated during the encounter. Eliminate fields with no date in general.

60. Easy access to saved / signed charts via OLEDB or ODBC so we can use a report writer to create a "pretty" note, (visual basic has very un-pretty printing capabilities).

61. Clarify the difference and allow for PMH, past encounters, and problem list. Past encounters are not problems. Problems are not PMH. Name past encounters by diagnosis not by chief complaint.

62. Allow the first page of the encounter to be face sheet. The first thing seen on the patient should be the problem list, past encounters, PMH, allergies, last A/P. This could be a preference.

63. The encounter in front of you should be dated when it was done not today's date.

64. Ability to add an actual comment field in ePrescribe so a certain pharmacy could be identified easily.

65. Present Encounters Page laid out so that chart's LEFT side contains all the fields that A) remain constant (FH, SH, etc.) and B) contains lists that are constantly updated and referred to (Med Lists, Problem List, Intervention List). The RIGHT side would contain the components unique to each encounter, e.g. SOAP note.

66. In general, the med list on the script writer reorganized. Should be able to see both active and inactive and see all pertinent information to each med without hovering. Inactivated meds should be visible with reasons for inactivation visible. Meds written times ten days for example should inactivate automatically.

67. The ability to populate the physical exam from a previous encounter (not the entire old encounter).

68. Store two or more pharmacies as favorites.

69. Ability to make Amazing Charts windows resizable as well as set their screen position rather than opening on top of each other.

70. Scroll bar for AC window.

71. Enlarge font in Imported Items.

72. Make the whole Imported Items to chart pop-up window larger.

73. Dropdown tab to see the last ten patients.

74. Make the immunization record the default view in summary rather than have to click on the middle tab. Improved immunization view (grid like).

75. Fix the DTaP comes with Td bug.

76. Ability to open the signed note from the Print Note Window.

77. Stop the backup of the .enc file from automatically going to the AC folder.

78. Reynolds Score.

79. Save weight only in either pounds or kilograms but not both.

80. Ability to prioritize certain ICD-9s so that they show up on the search list.

81. Ability to put shortcuts to websites directly on the top of the program.

Final Development Poll multiple choice, up to 20 choices
	. Imported Items Folders Stay Closed.
	Tracking labs/imaging/consults more efficiently.
	Word for letter writer and save in letter writer.
	Multiple charts open at once.
	Impossible to lose note. Smoother way to close note.
	Ability to add practice logo.
	Auto refresh messages with visual or audio alert.
	Adding pharmacy phone numbers.
	Increase abilities with email from demographic, e.g. export to Outlook or make distribution list. Exclude disabled patients.
	Rich text.
	Improved spell check with spell check saved on main pc and not on individual client.
	Choose own categories for imported items.
	Improve med and ICD-9 list.
	Ability to change the section titles.
	Add old vitals to growth curves.
	Export/import Rolodex and ability to always save.
	Both parents on demographics.
	Ability to edit the insurance list or other drop down lists.
	Better time tracking of patients either when arrival or in room.
	Ability to write more comments on scheduler that show up when printed.
	NPI and EIN in receipt note.
	Ability to remove multiple templates.
	Superbill before completed chart.
	Ability to edit completed chart with way to know it was done after the completed chart.
	Select printer rather than Preview Print.
	Ability to hide/delete actual worded diagnosis when using ICD-9 code.
	If vaccine Given Elsewhere, allow date to be "today."
	The reason for inactivating a drug window should be a preference. > 80% of my inactivations are obvious, e.g. antibiotics. Which should self-inactivate anyway after ten days anyway.
	Setting up labs should allow for comments but also for templates of associated labs that have no restriction on characters.
	Can reply to a message and send it back to person who sent it AND save it to chart with your reply attached.
	Do not auto delete deleted files when AC is restarted. This should be a manual process.
	Obstetrical record.
	Ability to open last note from Print Note Window.
	Improved process to print entire chart including imported items.
	Interface for Dymo Printer.
	Ability to enter lab data as discrete data - e.g. glucose, UA, PT/INR, chemistries, for in office labs that don't have interfaces. Would allow you to use data and tracked data is not overly useful.
	Inexpensive signature pad for front desk to sign in and sign HIPAA paperwork.
	Addendum with vitals so could do bp check, wt. check, etc. without showing as visit so you can still quickly highlight name and see when really last seen.
	User's manual preferably a downloadable PDF that also covers best way to install server and clients when upgrading.
	Ability to merge patients.
	When opening an imported HL7 lab report a button to open chart.
	Merge imported items.
	When scanning items be able to scan multiple sheets i.e. 2 lab reports - 1. Patient demo sheet -1. Insurance information sheet then be able to sort them into their correct categories.
	Everything and anything that has to do with the orders' section.
	Drag and drop OUT of Imported Items.
	Nested folders.
	Button on Imported Items page to open HM.
	Button on I.I. to send staff message, like in v4.
	Tabs to categorize and alphabetize labs, x-rays, referrals, etc.
	Would also like to be able to put clinic group names, as well as doctor names in Rolodex and Rolodex by speciality.
	Allow elective signing/locking of the chart.
	Allow multiple staff members with appropriate security access to the chart without having to forward it back and forth
	Add icons to increase room in the available fields ? icons are intuitive and gives more screen space for encounter fields. Change the upper large buttons to smaller ones or icons.
	Consider having the encounter fields small, but allowing them to expand as they are filled (so, for example, Assessment, if long, will not need to be scrolled through).
	Reformat the allergy field. Too much verbiage. Allergies only. No need for who updated when. Use a regular black font unless there is an allergy.
	Allow Users to populate their own Rx Sigs in the drop down list in ?SIG:? instead of just allowing stock ones in the drop down list.
	Add a 4th button on left that allows you to see the actual entire contents of all chronological Encounters and Messages in the right field
	Reduce the massive grey 1/3 left side of screen, which will allow you to make the print in the past encounters fields larger and more readable.
	Eliminate physical Exam: wt. Height? if field is not populated during the encounter. Eliminate fields with no date in general.
	Easy access to saved / signed charts via OLEDB or ODBC so we can use a report writer to create a "pretty" note, (visual basic has very un-pretty printing capabilities).
	Clarify the difference and allow for PMH, past encounters, and problem list. Past encounters are not problems. Problems are not PMH. Name past encounters by diagnosis not by chief complaint.
	Allow the first page of the encounter to be face sheet. The first thing seen on the patient should be the problem list, past encounters, PMH, allergies, last A/P. This could be a preference.
	The encounter in front of you should be dated when it was done not today's date.
	Ability to add an actual comment field in ePrescribe so a certain pharmacy could be identified easily.
	Present Encounters Page laid out so that chart's LEFT side contains all the fields that A) remain constant (FH, SH, etc.) and B) contains lists that are constantly updated and referred to (Med Lists, Problem List, Intervention List). The RIGHT side would
	In general, the med list on the script writer reorganized. Should be able to see both active and inactive and see all pertinent information to each med without hovering. Inactivated meds should be visible with reasons for inactivation visible. Meds writte
	The ability to populate the physical exam from a previous encounter (not the entire old encounter).
	Store two or more pharmacies as favorites.
	Ability to make Amazing Charts windows resizable as well as set their screen position rather than opening on top of each other.
	Scroll bar for AC window.
	Enlarge font in Imported Items.
	Make the whole Imported Items to chart pop-up window larger.
	Dropdown tab to see the last ten patients.
	Make the immunization record the default view in summary rather than have to click on the middle tab. Improved immunization view (grid like).
	Fix the DTaP comes with Td bug.
	Ability to open the signed note from the Print Note Window.
	Stop the backup of the .enc file from automatically going to the AC folder.
	Reynolds score.
	Save weight only in pounds or kilograms but not both.
	Ability to prioritize certain ICD-9s so that they show up on the search list.
	Ability to put shortcuts to websites directly on the top of the program.
Votes accepted starting: 02/21/2011 5:45 PM
View Results

We vote for 20.
Does this result in a prioritized list, with all suggestions still on it, or will those ideas below a certain vote total be amputated?

This will result in a prioritized list. The last two lists were only up for two weeks. This one is a "friendlier" list and will be up three months.

All ideas will be looked at, so even if one's idea received no votes, it would still be considered. You must remember, the devlopers/programmers may look at the top 20 and say, "There is no way to write code for the top 15. It just won't work with the program." While the lowest idea may be one that can be added with two lines of code.

Bert, you have been nominated as an honorary member of the Imported Folders Stay Closed lobby.

LOL. I had to put that up there. One of these days, you will have to tell me what that is. The issue, that is. LOL. It will still be a secret society, right. Like the dead poets?

Another suggestion: Have the ability to title our own group boxes and then have the ability to assign users to them. Need to be able to assign users to more than one box.

Here's another one. On the vaccine screen have a check box saying patient refuses this immunization.

This looks like a confirmation of my psychiatrist buddy's comment about trying to get a group of physicians to agree on/ move in any sort of collected or organized fashion as being something like "herding a collection of cats".
Looking at the reults of the poll I just completed ( "N" appears to be missing???) a BIG vote is 4 or more of us.
I think there may be a problem with sample size and sampling error.

My biggest problems are the way staff can easily trash a note by trying to close it, the whole screwed up orders/reconciliation problem, and the fact that the chart has to be forwarded and cannot be viewed by multiple people. I would also add that the quality of the printed noted is terrible. Every time I send a referral, they get a copy of my note and it looks really bad compared to other EHR printouts. This is BAD advertizing for AC. A poor looking printout with 'Amazing Charts' written right at the bottom. I would think they would want to START with this for PR reasons. The fact that reconciliation is so difficult has been discussed ad naseum, but never fixed. I am very enthusiastic about AC, and even feel defensive when people knock it, but these problems listed make it difficult, if not embarassing, to try and "sell" the EHR to other doctors.

I couldn't agree with you more. The letter writing and formatting has been discussed for seven years. I will say as somewhat of a veteran, that these things have been complained about forever with no one really addressing them. After finally writing them down, Jon has taken notice and make a real committment to changing them.

I cringe to at the way things look. Even in the past versions where you order something and it looks like this:

Advised/Ordered: CBC
BMP
CRP

I never knew why someone would not take one look at that and say I have to change that code to %IF Advised/Ordered|then Word next return one line&

But, at least we have them written out there and can talk about them in three months. I am not sure if Centricity users can do that.

On the other hand, I would rather have one awful looking note (remember I hate the way it looks too), then six pretty pages that Logician/Centricity produces for a sinus infection.

Bert, I thank you for all the work you have done on these polls. And, let me reiterate, this poll was a suggestion by members of the ACUC planning committee. The fact that only 11 have voted is a little disappointing. However, I still believe it is an excellent composite of the things most of us here on the board would like to see addressed. Its intention is merely to be used as a guideline. There are over 4000 practices using AC and over 2000 registered on this board. Now is the time to make your suggestions heard. AC developers are asking for our input. What other EMR would do that?

Can you believe that so far "Choose Own Categories For Imported Items" is number one. Of all the things we have complained about over the years, lol.

Post away. No longer an announcement. I didn't know you couldn't post to an announcement. Wow, I am not a very good "global mod." Guess I will need to be stripped of my global status, although I do like the color.

Thanks to Jon (the other Jon) for tipping me off.

From Barbara:

I tried to reply in the poll, but am told I'm "not allowed to reply in announcements".

Perhaps I missed it, or perhaps I'm the only one bothered by it...but I would love to get the old stuff out of the drop down menu for the problem list. Overtime that drop down menu is so full of inactive problems that it becomes unusable.

Thanks for the poll.
_________________________
Barbara C. Phillips, NP
Aberdeen, WA

From Jon (JBS)

You need to start a "get out the vote" drive. About 20 voters so far, out of 2339 forum members. Of course, maybe 2319 have no complaints with the program.

Keep in mind that the set-up of the poll will make the percentages look deceptively small. If everyone makes 20 selections, the MAXIMUM a choice can get is 5% of the votes. So at 4% for "categories for imported items"...that is almost as high as it can get (roughly 80% cast a vote for it).
_________________________
Jon
GI
Baltimore

I could have just merged the other thread, but I have done some merges in the past and lost everything. Just couldn't risk that.

Thanks Jon. I am not a statistics guru. I used 20 votes, because I thought people really wanted to pick things that were important to them. Not just five out of eighty. I personally had to keep taking things off to get from 30 down to 20.

I guess I don't look at it like percentages. I look at as Imported Categories has 17 votes whereas the Reynolds Score has one. That seem significant to me.

Anyway, Dr. Bertman may link from AC to the poll.

I keep telling you that Bertman is the other Jon, but somehow no one believes me.

No quarrel with the way you did the poll, I just wanted to point out that choices may be a bit more popular than the low percentages would suggest.

The wonderful suggestion (no bias intended ) of placing the constant fields on the chart's left, and encounter notes on chart's right got a bit trunkated in the poll. It currently reads:

"Present Encounters Page laid out so that chart's LEFT side contains all the fields that A) remain constant (FH, SH, etc.) and B) contains lists that are constantly updated and referred to (Med Lists, Problem List, Intervention List). The RIGHT side would"

Description Should read: "Place on Chart's LEFT side: all fields containing either fixed information (PMHx, SHx, FHx Allergies ) or running lists (Problem List, Interventions, Current Meds) , while place on chart's RIGHT side the fields renewable at each encounter. (Chief complaint, Subjective, Objective, Asmnt, Plan, Meds, Follow up)"

Eg:

CHART LEFT SIDE__________CHART RIGHT SIDE:
Problem List*________________Cheif Compliant
PMHx______________________Subjective
ROS_______________________Objective
Interventions________________Diagnosis
SHx________________________Assessment
FHx________________________Plan
Allergies____________________Prescribed Medications
Current Meds list*____________Follow-up

*Updated lists


Bruce Morgenstern, MD (Neurology)
Denver, CO

Jon (the Jon)

I understand better now. I kind of thought that way, but it still makes more sense now.

You know. In college, a lot of people called me Bert man as in Hey, Bert man. So, I guess I could be Bertman (the other one).

Bruce,

I thought about having the original ideas that people could refer back to, but it was just too much work.

Bump

This is one of the options for formatting notes in eClinicalWorks. I am seeing a lot of practices starting eCW now in my area, and I'm sure the formatting options are a factor. The cost is of course substantial (a two person practice was told $8-10k per doc plus $5k training plus around $800/mo, depending on PM options. There is also a 3-4 month delay for training/startup in our area. Again, all hearsay. But you do have the 3 month trial of Amazing Charts while you are waiting!

I have to say when I was looking at EMRs a while back, the two things that turned me off besides how gaudy most were back then, were the total price and the fact that you HAD to pay the outrageous price for training.

Even if one of your partners who just transferred from a practice who had used Logician for five years and could train everyone, you had to pay it. Imagine a car dealership selling you a car for $25,000 and also making you pay them $1,000 to teach you how to drive.

BTW, the one thing I would pay tons of money for would be the ability to have the EMR automatically code. Of course, that means drill down notes, which is what makes the note take so long to begin with.

How about improving the ENTIRE billing part of this program?
I think this should be number one on this list. It has to be a full circle from A to Z to match with other programs out there and be a complete EMR. Billing is the bottom line and that is very important. Enough with outsourcing and paying others for our hardly earned money! I do not want to use other billing software to bill for my encounters and waste time with double entry and interfacing (importing/exporting). AC staff need to show us they are really working on it and there is a deadline for this step. Just like with Apple say the new I pad will be out this date. They need to put this out there so we take their word more seriously than "oh ya it is coming out maybe March, maybe April, or Oh ya we are very close, we are working on it"

My suggestion for the poll, you can organize it better under separate titles and subtitles so it becomes a more efficient poll that is easier to go through instead of a run down list.

The entire billing program is the Practice Management program. Jon's biggest mistake is telling anyone when he thinks it will be out. It will be out when it is out. A program as complex and big as this is likely more cumbersome than you would think. I don't think it is fair to compare Amazing Charts with Apple who not only have 100 times the developers but also have been around at least five times longer.

As for the poll, I have already spent at least 15 hours working on the three polls. If you would like to make one be my guest. It's not intended to be the perfect poll. Just a list that people can check off a few things that are important to them.

By John:

"Imported Items Folders staying closed"

http://amazingcharts.com/ub/ubbthreads.php/topics/15714/Collapsing_imported_items_fold#Post15714

http://amazingcharts.com/ub/ubbthreads.php/topics/15810/Re_customized_imported_folders#Post15810

I absolutely understand that for primary care the imported items screen is probably overloaded with folders' contents.

For those of us in specialties, our pateints folder contents are usually much more managable and its a potential advantage to see their contents at one look (unless we are given a separate "intervetions" Field" to store most relevant data) -

Sounds like the perfect solution here is to make this an *administrative option*: "Imported Items Folders Default: Open/Closed" - (a potentially rare opportunity to please everybody?)

Bruce Morgenstern, MD
Denver CO

One of the biggest weaknesses I think is the lack of preferences. For instance, on the script writer, when you get to the last window where you decide how to print, the default is All Scripts on one page. If you want just one, you have to change it every time. It would make sense to have an option there.

I would like to have an option for checking in pts, you have no way of knowing if a pt has arrived. Also unless you have charted on the pt there is no way to quickly see if they had an appt in the past. If there is that option already in place I dont know about it.

Would be nice to be able to change or add things to vitals. In a gyn office, we like to put LMP on our vitals, and very rarely take temps, unless our patients are sick.

Dang, I didn't realize we were formulating a poll for feature enhancements. I would have included PLENTY of suggestions.

Examples:

1) Search Rolodex by Specialty <-- I don't think I'm alone on this one
2) Enhanced Reporting. Example:
a) export list of e-mails for patients scheduled on a particular day (to do confirmation e-mails)
b) include user defined appointment types in search (example, search for all patients who have not had their annual check-up in one year, and have it not pull their name if they had come in for an accute visit sooner,etc.)
3) More sophistication on Health Maintenance
a) Allow custom rules to be created depending on whether patients have a particular diagnosis (ex: abnormal PAP, must repeat in 3-6 months).

I hope hope hope some of these ideas would be taken into consideration!

Looking forward to some new changes!

- Sam

Ooh, LMP on vitals would be excellent. Right now we put it in PE.

- Sam

#50 15 votes so far.

I really want to see the Orders part of the program fixed. The whole business of reconciling orders and not being able to reconcile on import is hurting business for AC. This is a big complaint when I show the program to others. People in my area are really looking at new EMRs, and I'm promoting AC as I like the program generally.

Poll# 44. It only has 13 votes, so make sure you vote for it. A lot of these suggestions are already on the poll. They will get top priority.

Bump

Up to the top again.

Our front office place a CI (checked in) in front of name when checked in. And a NP new patient when checked in. Seems to work fornus.

1. Practice mngt please. We won't get obama money anyway.
2. Hipa compliant way to forrward from ac to patientbemail lab results. one way cimmunication. Get nurse off phone.
3. Medco etc mail ins. Enough redoing on their forms.
4. ADD rx scripts need to post date which comes out as .discontinued in note. Help
5. Template with full note diagnosis and even script say that
we personalize .
6. Massage every other day.
7. Do not lose my note.
8. Charge more...jk..

What do you mean by #4? Thanks.