Home Forums Discussions General Discussion Amazing Charts EMR

We are a two provider pediatric office and we are interested in using amazing charts as our EMR. We need several feedback from Pediatrician that are using Amazing Charts.

Again, welcome to AC. You will find the message boards very helpful and friendly. I would be glad to help as we have discussed.

Thank you bret,
We have paper charts now. What is the best way to tranfer all the paper document medical information of each patient to AC and where do you store those documents. What is the best scanner that you recommend. Do you have templates for health checks and immunizations that you can share...
Appreciate your input.
Dr Himada

I'm having good luck now with Fujitsu ScanSnap s510. It's small but powerful and reliable. I am scanning old files into pdf format with it. We are trying to scan old paper records for each established patient on the day the patient comes in for follow-up.

I am a new user, however. Others may have more experience. If you search the archives, you will find past discussions on this topic.

Thank You Dr Cotner.
I am pretty fast with hand writing documentation; how is it working with you relative to seep of documentation and what templates are you using especially for Health checks.
Your feedback is highly appreciated.
F. M. Himada, MD

Welcome to AC. You'll find us folk on the User Group Board very friendly and willing to provide helpful tips.

We are trying to scan in current patients as they come in also. If your scanner is not at your front desk, you can assign someone to "scan duty" occassionally and have them start scanning in the "A's", then the "B's". We use a Fujitsu 5110 scanner. Its kindof expensive and it multifeeds. At least mine does.

Thank u Wcoghill,
How do we fing u on User Group Board.
Dr Himada

Himada,

YOu have found everyone already on these boards. You can always click on their names and PM them.

As far as being fast with handwriting, I think you will find this is much faster and, of course, way more legible. Other EMRs have more bells and whistles, but AC is the fastest ever made. In fact, at Grand Rounds today, one of the physicians from our area gave a talk on Logician EHR and said you always have to see two to three less patients. We see three more.

As to templates, if you go to the last section on here which is Downloads, there are many templates to be looked at. At least I think so; I don't use them often.

Scanning: Fujitsu is good. Brother is good. You have to decide between scanning directly into a chart which can require importing. That's nice but time consuming. Otherwise, you can use a fax file system and fax to a different place, which would be much faster.

Himada,

YOu have found everyone already on these boards. You can always click on their names and PM them.

As far as being fast with handwriting, I think you will find this is much faster and, of course, way more legible. Other EMRs have more bells and whistles, but AC is the fastest ever made. In fact, at Grand Rounds today, one of the physicians from our area gave a talk on Logician EHR and said you always have to see two to three less patients. We see three more.

As to templates, if you go to the last section on here which is Downloads, there are many templates to be looked at. At least I think so; I don't use them often.

Scanning: Fujitsu is good. Brother is good. You have to decide between scanning directly into a chart which can require importing. That's nice but time consuming. Otherwise, you can use a fax file system and fax to a different place, which would be much faster.

I hear that Amazing chart is coming up with billing software in early next year, and what is the anticipated cost for both together? What will be the advanatage for it over the currently available interfaced billing softwares? I am thinking of switching from ECW use to Amazing chart, I tried Amazing chart 2 years ago for 2 weeks, but at the time it did not have many of the features that it has now. If I don't want to wait until early next year to switch to Amazing charts, what is the most preferred interfaced billing software among Amazing users?
Wish to hear from the users.

Thanks for all the users input.
Our next line of questions are specific for Pediatrician or FP using AC.
1- What are the templates available to be used for EPSDT/Well Child Check encounters that are age specific (n.b. I am using Bright Future anticipated Guidance and Health Check encounter forms)??. Please give us examples
2- In the state of GA, Parents are required by law to sign a consent for Treatment. How do we do that with AC??
3- Printing a prescription at the end of the encounter. Do you use the tamper Resistant Prescription pad and do you sign the prescription manually or you save the signature in AC???
4- How does AC generate a superbill for your billing department to proceed with electronic filing???
5- Can AC remind you if a patient is due for Immunizations or EPSDT check or Lead Screen Etc....
6- How do you enter the Immunization Record; Does AC have a specific template for Immunization??
We request from all the users Pediatricians or FPs to enlighten us about these matters for us to be on solid ground and before embarking on the implementation process. We appreciate any constructive and informative input.
Dr. Himada

1. It is easy to make templates on AC yourself. There are many in the downloads section of the boards. To be honest, I still continue to use Bright Futures in paper and then scan them as well as a brief note in AC. I am afraid Mainecare won't accept anything else. I do have an autofill form which looks just like it. I could have made it, but I had a company do it, and it's very nice. But, it's $50.00 per Bright Future form, which can get costly.
2. Well, unless you have a Tablet or some type of electronic signature pad, you would need to have them sign it, and then scan it.
3. We have printers in each room and print the non-controlled there. We have a Star printer with tamper-proof paper that we print CII to. I sign any prescription which is printed -- takes one second. We fax most of our scripts directly and without a signature since there is an electronic signature there. With new law October 1, 2007 for Medicaid -- must have tamperproof for all printed or written scripts, hence the faxing.
4. Multiple ways to print Superbills. But, will need to ask Donna J or Paul on here since they are PM/OMs.
5. It's hard to set across the board, but you could bring in a one day old infant, then set a reminder for one year and two years. You have to remember when I first bought AC, it was $250, now it is $995. It's simply not going to have all of the features that Logician has for $40,000 up front and $5,000 or whatever for ongoing support. My numbers for support may be wrong.
6. Immunization in summary area. Printout is nice. Still need a little work on the entry as it can be tedious. There are nice threads on that here.

Himada, I am certainly new to AC myself, we went live in April and we are trying to schedule a few less patients because of all the chaos, but the system is faster than paper, it is chaos in the rest of the office that is an issue. As a neophyte I still spoke for an hour at the state conference in Sept. and they have asked me to speak for two (long winded?) hours in February. While I am challenged by the computer issues I have begun to get a grip on the whole EHR and I am shocked how much I missed the point getting started. I would like to offer you some tips to help get started.
- Consider setting up a scanner to deal with old charts, and then shred them. The Cannon DR6080 turned out to be overkill, but we have scanned and shreded thousands of charts! The scanner came with software called 'Capture Perfect' and we love it. It stores the recordes on the server and leaves Amazing Charts un polluted by all of these old and useless records. They are INFINITELY more available than they ever were in the storage unit and any page needed can be output to Amazing Charts if needed. In California the old records now have to be saved for TEN YEARS and the storage costs are enormous, but don't worry about scanning in the chart right this minute. Go in the room with both the paper chart and the EHR. You MUST get the basic data in the EHR, (problem list, allergies, med list, DIAGNOSES) and eventually you will want to do them on the weekend or evening before. After a few months you will have days where most patients are already in, and you will be in heaven. TREAT THE BULK OF THE OLD CHART EXACTLY AS YOU WOULD THE FIRST VOLUME OF COMPLEX CASE, (geriatrics it is common for multivolume charts, Peds probably not?) Or you may think of it as the old records from another Dr. Glean out just what you need and enter it NOT AS A PICURE OF PAGE but as real useful data entered into fields. Carry the chart as a security blanket as long as you like, but then scan it to the server and shred it!
- What is so important to understand is that the EHR is a tool for the practice of medicine NO LESS THAN YOUR STETHOSCOPE and it is a database you are building. What matters is what goes forward from now, not the old records, (paper under glass) that you scan in. The real impact of the EHR will be felt by your patients in the years to come as we all strive to achieve the 'Medical Home Model' practice that promises to revitalize heath care.
- The world is not paperless, and your practice is not likely to be any time soon. Don't stress about it. (For two months while we tried to figure out the computer issues we took Faxes from one server, printed them, scanned them into AC and then shredded the paper. Stupid, but still WAY FASTER than anything we have ever done before. Give your staff enough tools, we have 9 points in the office where material can be scanned in and plan to buy two more right away, ( the staff fight over the little Cannon 2050C) but guess what. Our first thing we used AC for was storing the new labs, x-ray, consults and so forth, and within a month we settled into a rhythm where ALL FILING IS FINISHED BY 5:00 PM EVERY SINGLE DAY. Awesome, you can't believe the time that is freed up when paper is handled just once, then shredded and removed from the work flow forever. Can you guess howmany times a month I use to leave the room and wait while two or three employees would stop what they were doing to look for a report or call the lab to send us yet ANOTHER copy that would need to be filed? Why did we do this for so long?
- Most important tip I tell everyone, DON'T WAIT. You may someday know enough to pick a software that is better suited to your practice than Amazing Charts, but you will still be WAY BETTER OFF if you start now. We chose Amazing Charts fulling expecting that we would want to switch in one to two years, but we were unwilling to commit to the pricetag of the overpriced ones until we were more clear on what we need. Now that we are using it, and at the rate Bert keeps improving it, I can't imagine changing. It is awesome. Do what we did, just use it for the filing for the first month, and put the original paper in a box without shredding it. Once we got it going we knew right away, I would slit my wrists, rather than go back.

Couldn't agree more. Make the leap. Scan and shred. Too bad you can't do it all at once. Simply scan to the server using any software you choose -- we made our own software -- but many scanners have their own, and there is also www.scanaway.com.

BUT, make sure you have at least four to five ways of backing up the data scanned. Don't just burn it to CD or DVD and take it home. You need multiple backups AND redundant backups, i.e. backups a month deep at least if not a year.

Cheers!

Bert,
I read the excellent article in mdng. Thank you for the input.
I would like to discuss certain issues on the phone if you do not mind.
Thanks for DocMartin on his tips. I understand your confusion. I am taking the conversion very slowly and I am studying all aspects very carefylly and I am preparing the ground for EMR before embarking on it.
Bert, I do have the fujitsu 5120C scanner now and I will be using e-bridge solutions as server for storage of scanned documents (old Charts). I need to import these documents to AC on each patient; Give your feedback.
Another issue is the prescription; Can we efax the prescription to Pharmacies with AC??
We need to know as well what would be the best computer tablet that is compatible to see AC patient charts clearly and completely; give your perspective.
As far as MED list for Pediatrics; what are you using yourself with AC.
Finally, give me the disadvantages that u are encountering now in your practice frankly by using AC. and what do you like to change and have in AC in the future????
The input of other users is also appreciated..
Dr Himada

Himada,

I would be glad to go over any aspect of Amazing Charts with you by telephone. I will give you my phone number via PM. You are wise to undertake it very slowly. I don't think the actual program needs a lot of time to implement, but the strategies for backups and importing do.

I am not very familiar with e-bridge solutions (I glanced at the website), so maybe someone else could help there. I am very big on redundancy and backups. Two biggest problems with data loss: hard drive crashes and human error. With any billing program or EMR, I would start with the server and work back. If possible, using RAID1 or RAID1 plus RAID5 (we use RAID5 only) gives you better performance and redundancy right away. While very good backups allow you to recover your data, you will still be down at least one day if not more. With RAID1, you will only experience a hiccup, if that, and it will only be important to replace the bad drive ASAP. And, with RAID5 plus a hot spare, you can lose a drive and not even know it and it would rebuild to the hot spare. One only has to replace the bad drive, and it becomes the hot spare. Very cool set up.

Then, of course, you need complete and redundant backups of the ENTIRE server at least daily along with specific backups of your imports, AC and billing. I am not sure how this would work with your e-bridge or if it would make these other steps not necessary.

Yes, you can eFax with AC. Basically, after the prescription is ready to be printed and is in the preview mode, you can do anything with that prescription that you could do in Word. eFax may not be the cheapest. RingCentral is cheap and there are others. I used to use RingCentral, and I found that I lost about 1 prescription in 15. You are much better off with a networkable fax machine that allows you to fax directly from your modem. In this way, we have lost none out of thousands, and it is free. Either way it works off the print setup and print drivers. One user on here uses ActFax http://www.actfax.com/en/ which I believe is a one-time purchase where you fax over the Internet. Our fax machine is capable of faxing over the Internet, but the pharmacy you are faxing to must have the same capability.

I can't say much about Tablets as I have never used them. I imagine they are all pretty good, but there are threads on here devoted to that section. These are all my opinions, but I am a big believer in desktops everywhere AC is used including the exam rooms with printers.

With MED list for pediatrics, if you are referring to the database, I made my own which you can download at http://tinyurl.com/26bb3x I am about to upgrade to a new version and simply the database, but basically it will be the same. I would make it open source, but I am too controlling at this point. Maybe down the road a bit.

The last topic has been hashed and rehased among users from when AC has been first introduced. First, it is a fairly rock solid program that for the cost is unbeatable.

This is a lists of changes I emailed to some friends on here with a couple of tongue-in-cheek ones which I hope don't offend anyone. There are a lot of changes people want but Jonathan probably doens't have time to implement all of them.

•Change Past Visits so diagnoses populate instead of chief complaint
•Change prescription writer so you can save certain scripts like Prednisone tapers
•Change databases so one can enter “dummy patients” for learning without counting them toward the real database
•Added one click backup
•Change the EULA to read, “I love you, you love me, we all love our great AC.”
•Changed saying on initial Amazing Charts screen to say, “I hate Medicaid” or “Boy, it sucks to be a doctor.” Instead of “Make it home for dinner.”
•Change the summary sheet to include a real problem list.
•Change orders so that only current diagnosis populates the requisition so that an MRI doesn’t have diagnoses of Seizures and Intestinal Parasites.
•Change immunization record so that A) one could delete the 50 old Expiration dates and Lot numbers, and B) so when Lot# B297C6 was entered it would automatically populate the field with Hib, Merck, 9/9/2008, 0.5mL and IM, etc.

Personally, I would like to see the code changed so that windows opened within windows rather than always opening in different windows which slows the program down considerably.

Cheers!

Yes. AC is fast, but probably could be much faster with paring down baggage that most users don't need.

Bert,
Thanks for the feedback. I could not open the MedsDatabase. Could you email it in another format.
I will be calling you soon.
Dr Himada