Home Forums Discussions Feedback and Recommendations Editable PMH field

One of the most valuable improvements would be the ability to add and edit the PMH field in between visits without having to save any change as a brand new note. As we receive test results or notes from consultants, we need an easy way to update the patient record.

When I receive that type of stuff I update the "diagnosis" section or the "alerts" section of the summary sheet and have trained myself to cross check the summary sheet with the PMH when I see the patient. I use the"alert" section of the top right of the summary sheet to list procedures (CABG, cholecystectomy or whatever) that would not necessarily be included in the list of diagnosis. I list colonoscopy. mammography, ekg and that sort of thing into the tracked items section.
One grouch I have about the summary sheet is the inability to read the entire entry.. "personal history of malign". Maybe somebody brighter than I am knows how to read the whole entry.

I agree with billfox. I never seem to use the summary sheet tab. I got AC because I can see everything on one screen, the most recent encounter screen.

I would love to edit all the fields individually or together without saving brand new note like the allergies update function.

Hope someone is working on this one.

Deborah. That's alot of work to cross check, but whatever works for you.

I also agree. Would be nice to be able update social hx as well. Also would be nice to record a BP check without creating a new encounter note. If you do just create an encounter note for a BP check as I have in the past it negatively affects certain meaningful use tallies.

Totally agree. If the dx we enter went into the PMH as well as the Problem List, it would save tons of time.

I am starting to believe that this reauest forum is all hopeless: That this user-board just serves as a frustration release valve, and that the myriad of practical improvements suggested by dedicated and intelligent users will never go anywhere (wittness the apparent years of requesting a letter writer that isn't primitive - no change).

Below is a suggesion I made to AC months ago - similar to your request. I don't believe anything will ever happen with it.


" The contents of the "Problem List" space should always be easily visible and should auto expand to actually *show * the contents of the problem list - it is our guide for each patient ? it should be plainly visible , the problem list should not simply read, "Problem List" until you click on it, it should spontaneously show the actual problem list for that patient (Would you rather drive a car whose windshield clrearly showed the complete road ahead, or drive a car whose windshield was plastered with the label "Windshield" placed opaquely across it (to remind you it actually was the windshield) , but only actually showed the road ahead when you clicked on it. )

Bruce Morgenstern, Neurology
Denver, CO

Of course it serves as a frustration release valve. It is not hopeless. They do intermittently monitor it, but not consistently.

They are continuously fixing things, just not always the things that you want (they fix everything I want, ha ha (yeah right)) We may have a different set of priorities than they do, but things do get fixed eventually. You have to take a long road view. You are in this for the long haul.

If you look at what was corrected for 6.0.9, it is actually quite substancial. You cannot accuse them of resting on their laurals.

V6.09 6/15/2011 Meaningful Use (MU)
Added Meaningful Use wizard with onscreen instructions to help follow MU goals
Added description and How To section for each MU criteria on the wizard
Added MU Checkpoint to follow MU goals during an encounter
Added color coding to MU related buttons and functions
Added ability to export to Personal Health Records (PHRs) and setup options
Updated our CCD and HL7 files to meet all MU standards
Can import both CCD and CCR into patients' imported items-Enabled Formulary checking
Added tobacco dropdown to Most Recent Encounters and display smoking status codes in mouse-over
Added 'No Active Meds' and 'No Active Diagnoses' buttons
Can export to Immunization or Public Health registry
Added ability to merge 2 patients into a single patient
Updated reasons dropdown of HIPPA release to be codified with reasons that match MU criteria
Added ability to encrypt/decrypt files
Added tooltip descriptions to MU buttons
Added saved MU queries
Added alert if drug-interactions are turned off (as this is required for MU)
Letter Writer can print CCD and has dropdown for Reasons


Admin
Corrected audit log entry when printing completed HMs
Can sort by audit log by Description
Corrected issue where Missing Import Utility recreates links for previously deleted imported items
Can now add/edit Facility and Location names and addresses
Made icon to export all patients' CCRs inactive
Centered Admin screen in main window
Restored Miscellaneous field to Import Utility
Added warning when changing provider level, if scheduled appointments will be removed
Can block a physician for accessing a chart (but allow emergency access)


HM (now called Decision Support)
Added ability to completely configure decision support rules, including by: medication, diagnosis name, diagnosis code, gender, and/or lab name and value
Updated USPSTF guidelines
Date given calendar dropdown no longer closes before altering date
Corrected issue with unselecting ?Had Infection?
Vaccine Date Given defaults to current date
Improved refresh speed of decision support window
Expiration date of a vaccine linked to lot number
Can remove and restore original conditions from default decision support rules
Given Elsewhere also locks field in HM edit screen
On Summary Sheet changed name of ?Add Rule? to ?Enlarge?
Changed button name of ?Save? to ?Migrate This Patient Only? on the patient vaccine migration screen
Changed name of vaccination route from ?Buttock? to ?Gluteal?
Injection information now populates Plan section of chart
Ignore All HMs button will automatically uncheck all HMs
Edit HMs screen dropdowns now pre-populated with complete info
Added title to all pages when printing HMs
Correct issue where Procedure field wasn't saving for injections
Added old/out of date vaccines (OPV, DTP) to vaccine list
Will automatically add manufacturer when vaccine is selected
Added date and time to immunization reactions
Full HM information entered in Plan section after HM is given
Corrected issue where vaccines only show when Brand Name checked
Corrected issue where giving 1 vaccine can show twice
Corrected issue where influenza shows as High Risk
Added time given to immunizations
Added ability for decision support to automatically update while chart is still open
All non-immunization HMs no longer have maximum interval
Changed 'Date Given' to 'Date Performed'
Fixed bug where vaccines entered in the past showed as given today
Vaccines doses that are refused, show in Summary Sheet completed grid highlighted in red
Vaccines now add correctly to addendums text
Added minimum interval to Td, Unknown vaccine
If there is a VIS name for an immunization, the VIS date given will default to current date
Improved way we erase dates in HM: Immunizations



Demographics
Added a new section for Next of Kin/Guardian in Demographics
Added a contact preference field to demographics
Added time field to DOB
Can express newborn child's age in hours, days, weeks, and months
Added ethnicity and language preference to demographics
Added a VFC field to demographics
Corrected issue removing referring providers
Improve keyboard tabbing through demographics
Comments in Demographics/Referrals are now visible without scrolling


Charts
Provider credentials are now listed when signing a chart, message, or addendum
Fixed issue with addendum date change
New checkbox to document distributing patient education materials
Added a Resolved category to diagnoses in Summary Sheet
Corrected issue when vital out of range on More Vitals screen caused shut down
Can now enter Resolved and Inactive diagnoses with prior dates
Entering vitals in past, now puts in correct date
Corrected issue where curser moves to the beginning of the plan section
Can now graph all vitals (including those in More section)
Corrected issue of incorrectly updating Current Meds when opening forwarded chart
Can now close addendum without closing open chart
Opening a chart no longer marks it as changed
Fixed issue where forwarding a chart could change head circumference unit from inches to centimeters
Correct view if patient has more than 10 Risk Factors
Allergies now print from File/Print on Summary Sheet
Can add both Patient and Practice templates to chart
Correct issue opening chart with ID > 32767
Improved speed when opening reminders


Medications
Fixed an issue on eRx authorization, where authorization and Write Script screens could get merged
Added Drug-Allergy interaction alerts on Write Scripts screen
Can override drug interactions by double clicking on drug-allergy interaction
Created a filter for drug-drug interactions based upon severity
Can now hide or show overridden drug-drug and drug-allergy interactions
Pharmacies that do not accept ePrescriptions are highlighted in yellow on Transmit prescriptions page
Can check formulary for eligible patients in Write Scripts screen
Can add a note on all future prescriptions
Favorite medications lists are now provider specific
Added links for medication information for prescribers and patients
Can re-print and re-transmit a medication without rewriting the script
Will now see drug interactions from Allergy screen
Medications display and are printed in alphabetical order
Added link to Dose Calculator from Quick Script Writer
QHS now displays as nightly in Sig
Dispense number dropdown displays numerically
Made drug interactions columns section resizable
Selecting NONE on the Quick Script Writer, enters a '0' in Disp #
Added a provider option to prevent provider's name from showing twice if it is the same name as the practice
No longer need to save Current Meds twice
Corrected issue where providers name can be repeated in dropdown lists
Can now send free text medications through Surescripts ePrescribing
Added a warning and attestation, when prescribing free text meds, that scheduled drugs cannot be sent electronically
Updated TSP printer formats to be compliant with all state regulations
Write Scripts screen now automatically closes after completing a prescription
Moved the icon for valid eRx to the left side of the screen
Medications prescribed for the future will have Date Prescribed: ?date? added in the Plan section
When writing multiple prescriptions, with future dates, for the same medication on the same day (i.e. Adderal), we no longer display that the medication was discontinued in the plan
When inactivating a medication, comment now shows in medication History
Added a counter to show how many Active Interactions on Write Scripts page
Corrected issue where Alka-Seltzer can have an interaction with itself
Corrected spelling error in message when trying to enter free text in the Current Meds box


Labs/Interfaces/Imported Items
Can import Practice Documents into patient's imported items
Deleting an imported item will now delete item from folder, or alert if it cannot delete the item
Labs can be sent to non-ordering provider when ordering provider isn't found
Improved lab display format to include address of lab, date/time of specimen, condition of specimen, and type of lab
Double clicking on an Orange test item with automatically open the note
Can recognize lab type in OBR.24 field
Corrected message about not being able to enable iPhone interface from synced computer
Added new filed to indicate preference where notes should be displayed
Fixed error when signing lab on a mapped drive
Corrected bulk schedule import with Phreesia
Corrected issue in Phressia when Misc 1 field was populated, it was being exported as patient ID
In Phressia import, look at Name and ID in addition to DOB when deciding to create new patient
Can now read patient's DOB when it is sent with hours and minutes
If Clinical info field is truncated, we add the text 'TRUNCATED'
Now import guarantor DOB from GT1 field if information not in IN1 fields


Messages
Fixed issue where chart no longer attached after forwarding a chart
Limited 'Re' field to 100 characters to prevent errors
Non-providers can see items Labs inbox
Give option to undelete message if now changes made to chart when opening a chart from a message


Orders
Guarantor information added to order requisitions
Added ability to Delete and Modify orders
eSignatures now print on order requisitions
Can print a patients' orders from Past Encounters screen
Corrected error when printing orders by right clicking
Added Type to orders in Past Encounters
Improved lab description when linking labs to orders in View/Orders
Added ability to remove Orders that were Quick Added
Added templates on the Completed orders screen
Corrected issue where selecting Groupboxes to send orders to would change to a provider with the same name


Renewals
All Denials are unchecked by default, but will check automatically if any action is taken
Renewals screen can be sorted by Date, Patient, or Action columns
Double clicking on a medication box when patient is already matched, goes directly to medication matching
Updated demographics field and instructions
Show Mine/Show All radio buttons will save what was selected last time (by user)
Now show both users?s pending renewals and all pending renewals on main screen
Added graphical display when sending and receiving renewals
When matching patients, inactive patients are grey highlighted
Changed verbiage when matching different patient or med
Checking for new renewals every 30 minutes
Transaction status refresh button fixed
Fixed issue when viewing transaction status and filtering with dropdown


Schedule
Corrected issue where remove/reschedule appointment not working if Schedule Change Notifications were off
Added time to message when cancelling an appointment
Cancelling the editing of an appointment no longer show reminder screen about change
Missed appointments now show the correct date
Changing a scheduled appt now sends the correct date


Search
Can now search vaccine information (name, lot number, date given)
Can search Tracked data
Can search non-numeric lab values and inactive meds
Results column will show what was search for when searching HMs
Phone number searches can now be run with 'contains' and 'begins with'
Schedule drag and cancel now cancels correctly
Restored ability to search by CPT code
Added ability to search by drug class
Can search weeks until next visit and months since last BP reading
Correct issue where Print button wasn?t showing Preview before printing
Search criteria displayed in results grid with OR searches (previously only displayed with AND searches)
Fixed issue where patient could be displayed twice
Corrected BP search to run properly and updated text that indicate most recent BPs are being searched


Sync
Synchronizer no longer runs in background after closing

Printing
Can print encounters by date range (now includes SOAP notes, addendums, messages, problem list, meds list, inactive meds, allergies, labs, imported items)
Revamped our Print and Export CCR/CCD
Added Preview button to Letter writer, so Print button now automatically prints to default printer
When printing past encounters, we now automatically add carriage return between sections (i.e. HPI, ROS, PMH, etc)
Fixed the Print button on Practice Documents to work with a variety to forms
More vitals now print
Corrected error when printing a Formal Health Record in a patient with no encounters
Can Print to printer with multiple trays


Billing
Added the billing (CPT) modifiers 'GA' and 'SE'
Now exporting Superbill location to AC preferred 1500 export
Corrected issue where number of units for a CPT could change in Superbill

Other
Fixed issue of patient relationships to guarantor not importing correctly when importing demographics
Meds, Allergies, and Pharmacy tables updated automatically
Fixed runtime error when shutting down Amazing Charts
Bulk order sign off won't sign off non-medical items
Practice names can start with a number
Updated log of patient changes to remove fields no longer in demographics
Vaccine export utility now only reports on vaccines to be migrated (as opposed to all completed HMs)
Merged 2 forms used when verifying eRx from Write Scripts screen
Fixed error 91 when shutting down Amazing Charts
Show edited ICD9 codes in ICD9 search box
Removed unnecessary auditing of repeat events (like copying Templates upon creating a new provider)
Now hide filename in Practice Documents
Passing to New Crop and Surescripts Practice Name and address from Set eRx screen
Fixed grammar in trial period licensing info
During setup, corrected issue with Enter button on Reseller screen
Updated copyright on splash screen to 2011
Tuner will now clear the word NONE from DEA # box in User Configuration (a blank box is acceptable)
Correct spelling of 'cooking' in ICD9 code E015.2

I don't know where you found this but it is impressive. Unfortunately I think each person has their own feature that they would like to see fixed or improved, that being said each major release has a number of fixes that you or I never had issues with.

Unfortunately the 'Star Printer upgrade so it will not print' is not one of their best features since the star printer is prominently displayed on their site. Hopefully they will get that one fixed soon.

Wendell,

While you certainly list a number of laudable changes, these are mostly, in my opinion, either "tweaks" to correct existing flaws in the program, or movements towards meaningful use.

What frustrates me, however, is not these corrections, it is the lack of movement to a "bigger picture" , a vision to make this a program that truly soars with versitility. Such changes could include an improved letter writer, and easily accessible problem list, a place to easily store and access interventions or drug experiences (ie pt became hypotensive on inderal), chart fields that expand to show their full contents, an accessible drug history that documents precisely what Rxs were written by the provider, etc.

These, IMHO, are the changes that would lead AC to become a great program. Instead, the changes that seem to be taking place are incremental to keep the program competent, and from sinking into awful, but they don't necessairly make it a great or flexible program, just one that floats above mediocrity.

This program, as it evolves, seems to lack precisely what Steve Jobs was lauded for: Vision and Innovation

. .. and that is what frustrates me, and has me and my office actively searching for a different EMR.

Bruce Morgenstern (Neurology)
Denver, CO

All EMRs have been at the mercy of the Federal government, since criteria were not forthcoming until the fall last year. Many of the problems of the program are being dealt with. Many of the governmental mandates MUST be met to make it commercially viable. Of course they are following the MU trail. Beyond that, first make it right, then expand.

Everyone has a different set of criteria they consider important. I do think the letter writer is important but don't care about the problem list (all you have to do is click the problem drop down menu). But ultimately decisions are made to make changes both based on perceived importance and ease of completion. Personally I would rather have a PM.

My point was that problems are being dealt with and a lot of them, just not as quickly as we might like, and not always in the way we might like. But each of us has different requirements and expectations. Perhaps AC fits, perhaps it doesn't.

Disclaimer
I have no financial interest in AC and truly do not have any inside information about the company or it's direction. I base my opinions on past experiences and prior conversations with JB. I am not in frequent contact with him. My opinions are just that. I do feel that they are consistent with how AC has proceeded in the past.

While one may argue that all preferences are relative, that a Problem list clearly displayed is important only to some, that a functional letter-writer is only ilmportant to some , sometimes, with vision, intelligence, common sense, and perhaps good use of feedback, a companyand product simply "gets it right" - by anticiapating to and respondin to peoples needs and wants, in a sophisticated and elegant way

While the i-pad or i-phone may not have fully satisfied every person's preferences, clearly thoughtfullness, innovation and responsivenss produced a product that pleased an awful lot of people, at least in part with a visio n that combined sophistication with simplicity, and thoughtfulness of design.

I'm simply wishing, sadly, that AC could be more like that . .


Bruce Morgenstern (neurology)
Denver, CO

While one may argue that all preferences are relative, that a Problem list clearly displayed is important only to some, that a functional letter-writer is only important to some , sometimes, with vision, intelligence, common sense, and perhaps good use of feedback, a company and product simply "gets it right" - by anticiapating to and responding to peoples needs and wants, in a sophisticated and elegant way

While the i-pad or i-phone may not have fully satisfied every person's preferences, clearly thoughtfullness, innovation and responsivenss produced a product that pleased an awful lot of people, at least in part with a vision that combined sophistication with simplicity, and thoughtfulness of design.

I'm simply wishing, sadly, that AC could be more like that . .


Bruce Morgenstern (neurology)
Denver, CO

I have watched this thread with interest - we each have items that we want fixed, expanded, changed. Unfortunately I agree with Wendell it only made sense to succumb to federal mandates (I attested to 90 days of MU today and am waiting for my check) as things like CCHIT and then MU certification meant a lot to different people.

The letter writer is basic - many of us would like fancier fonts, letterhead, graphics, etc but it does a basic letter with it being easy to put any part of the exam, history, old meds, new meds, assessment and plan in it - I often give patients list of diagnoses, meds, plan etc and sometimes write referral letters to specialists - since 'consult' codes have gone by the wayside more and more of the specialists I know send me a generic letter with 'thanks for consulting' and the plan along with a office note attached. I think that if we as physicians concentrated more on accurate records and less on our letterhead, etc then EMR records would be better.

I hope that someone dissatisfied with AC finds one to their liking unfortunately I think that over the next 6 months they may find that the EMR they chose does not follow the direction they want... Good luck.

I have used AC for almost 10 years and have played with many, many versions including almost all alpha, betas and general releases. It does a good job and is constantly evolving.

P.S. I love my Ipad but wonder why their 'innovative design' did not include a camera.....maybe to put out version 2 a year or so later with a camera. Don't get me wrong I love tech and my Blackberries, Droids, Ipads, Iphones, and myriad of other gadgets will attest that I buy a lot of them. You just have to wait to see what comes next.