Home Forums Work flow question re: multiple charts open at same time

I am a new user in trial period. I have not been able to open more than one patient chart in AC at one time. This, I assume is to avoid errors in writing in the wrong patient's chart etc. However, I see a major problem here with the workflow in my office as my 4 MAs might open and write in upto 5 charts in 5 minutes (we have 5 rooms, 2 docs and multiple procedures (Strep, U/A, blood draws) on 5 patients going on at the same time). How do I make it so they can access multiple charts quickly? I really don't want to buy a laptop for ea of them! Does having multiple users in windows 7 allow "multiple amazing charts" to be open on the same PC?

Welcome to ACUB!

My office is a one doc operation, but when I first started using AC I couldn't imagine how I could get by with only one chart open at a time. Yet, now I'm used to it and it works fine and doesn't impede workflow. The key is the Message window which is the hub of workflow in AC. My MA will open a chart, document the cc and vitals then save the chart to the Message window (Control-S). When I go in to see the patient I retrieve the chart from my Messages. After seeing the patient I often will save it again before I finish charting. In effect I may have multiple charts "open" at the same time--on the Message window. There are a few situations where it would be nice to actually look at two charts simultaneously. For example, I'm seeing a young girl and trying to remember what antibiotic I gave his brother last week. It can be done one one computer--but is a bit faster with two. In my office I use two laptops. One stays on my desk and the other I carry with me. Using two computers I can open the charts of both patients. Most of the time it's not necessary. Having two computers has other advantages--if I forget to recharge one machine's battery during lunch--I still have the other to use in the afternoon.

As you work with AC you and your staff will develop workflow protocols so that the process works smoothly for you. It takes time to work it all out.

With best wishes,

John

John's reply is quite accurate. You cannot open multiple charts on the same desktop. In our office we do a similar thing. The MA documents on a patient (vital signs, smoking status, reconciles med list), the forward the chart to my AC desktop (the Messages Panel). Then she moves on to the next patient.

Here is an example of how I use the AC Desktop/Messages Panel: I often will chart on a patient, forward the note to my Messages Panel to finish later. Then I may open another chart to complete a note and sign it. Then I have to answer a question from a message sent to me (i.e. a patient phone call/question about a med), then I might open that chart to check something, and reply to the message and send it back to my staff. Then I will open another chart to finish documenting the note and sign that note. The next note may be one that I partially document and send back to my desktop for completion later.

It's very easy to open charts and forward them to the appropriate desktop. Then open another, work on it, and forward it to the appropriate desktop. It sounds like your MA's simply need to do this and you'll find the work flow modifies easily.

I hope this helps you. Good luck with AC. I've been using it very productively for over 4 years in an extremely busy family medicine office.

Don't forget you can just press Ctrl S to SAVE it to your inbox. I do this all the time, and once I started the habit, no danger of pressing the Red X and losing the chart.

One advantage of having only one chart actively open at a time is that it helps prevent careless docs like myself from putting the BP on the wrong chart. :-)

Thanks a lot for all the answers. It makes a lot of sense that I can forward charts to my inbox- so I am not really 'closing' them, just putting them aside. However, is it true that nobody else can open/document anything on that chart till it is cleared from my inbox?

This is one the reasons I find LogMeIn invaluable: multi-tasking... have one chart open on my tablet, then if I need to do some refills, check another chart, etc without having to close the "active" chart, I check AC on another computer (my office desktop) through the web browser on my tablet. Very easy and efficient.

AJ, info can be documented to the chart, but not to that specific note. So, nurses can save addenda, refill meds, etc from another computer on that patient, but it won't be saved to THAT encounter note (but will be in the other "pages": med list, summary, immunization record, etc.) Encounter-specific info (vitals, HPI, etc) can only be entered into the active note, whoever has it (you if you sent it to your own inbox, your nurse if you sent it there)

My MA and I use the same User Account. Her Inbox and mine are the same. When I save a chart to my inbox she can open it and document. The other option is to have separate accounts and forward the chart to the MA's Inbox. There are various pros/cons to either approach. We've tried it both ways and find it easiest to share the same user account.

Messaging gets a little tricky with the same user account. What I do is when I'm sending a message to my MA, Rhonda, I send it to my account and add "Rhonda" in the "re:" line. When she looks at the Inbox she can see that it's a message for her.

No doubt other users have worked out other systems for dealing with these issues. There is no "one" way to do things.

AJ

To answer one of your questions, no you cannot have multiple AC programs open on one WIN 7 window. You can however have multiple people logged in and have that many ACs, but that is pretty much useless switching back and forth.

I must be in the minority, but I have not in eight years or more found myself wanting another chart open. A lot of new users make this too hard. Just open the chart the MA triaged for you, see the patient, document it and save it. Yes, you can "park" it or save it for a bit, but I would try not to get into that habit. Finish your notes before you leave the room and at the end of the day, you can go home. See how well it works for me. I am all done. Only 10:45 pm.

If you have five MAs, then give them five computers. Kinda makes sense. If you are that busy, then you are making that much money, you should be able to afford them. You really can't have MAs sharing one computer.

The other way is simply to have a desktop in each room, have your MA take the patient back, open the chart, enter the vitals and how much of the subjective you want and have her forward it to your inbox.

Alternatively, rather than LMI (if you want), you can put virtual machines on any of your PCs. You could conceivably be running 10 or more OS on one computer with 10 ACs open.

AJ, we use separate user profiles in AC. However we all have the SAME password. this way anyone can check another user's AC desktop.
So if you saved something to your desktop and the MA needs access to it, so can log in as you with your common password, chart on the document and return it to your desktop.

Or like other users, you and the MA could share the same user profile. I can understand the need for security but I look at it this way. What if I sent something to the MA tonight after hours and she calls in sick tomorrow? How can anyone address the messages that I sent her unless they know her password. So we all have the same simple password for the AC desktops.

Just FYI, you can go into your messages, change "inbox" to "outbox"
highlight the message you sent to your MA then click on "retrieve"
This places the message back into your inbox and she will not see it

Yes, it allows saving of face!