Home Forums Discussions Feedback and Recommendations Ability to Bold on the ROS

I recently recieved patient records from a physician who uses Centricity EMR and found the ROS helpful in developing my own.
I especially liked the fact that all positive remarks on the ROS were bolded for quick identification. I use Dragon and attempted this with AC. Although I could easily bold my transcription by saying "Bold" while dictating into Microsoft Word using Dragon, I could not do so within AC. The best that I could do was to use "All Caps". I spoke to Jodie on the AC support and she told me that, currently, AC does not support Bolding. It would be great if it could do so at some point.
Best,
Jim
FP
Springfield, MO

Jim,

For now all caps is your only option. The technical reason for this is that in Amazing Charts, the various boxes are textboxes, not rich text boxes. Jon has considered making the change, but unfortunately it's pretty invasive - not an trivial change - and could break a lot of things that would then need fixing before the system could be released again.

It's on the to-do list, but unfortunately not very high on that list, as is a small gain for a LOT of work.

Regards,

V.

Another useful idea would be to allow a Check box or and X - box, or also a [--] or a [+] box this would help to denote the pertinent pos and neg ROS. The same thing would be useful in the PE section. Lastly, could we change the font to a non-proportional font, so that the spaces line up when we tab in on our exams templates. At the present time the tab line is all over the place and the notes appear ragged.
PS I posted on this issue in the previous Discussion board but never got a response. Could you comment Vinnie? I would love to illustrate to you what the note looks like and what I mean if the above message is not clear.

Thanks Neil E Goodman MD

Hi Neil,

Where ya been. Must be caught up with the Bulldogs. Wish they could have played for the national championship instead of LSU.

I'm with you on the formatting. Not sure what the fonts are, but I think one of the biggest problems with AC is the formatting of the progress note and the letters.

There are little things that would be one line change in code (I am guessing). For instance, when you write labs in the order writer, if you don't skip a line, the first lab is on the same labs as Ordered. It looks terrible, so you have to either start a line down or move it on the note. Same thing with Meds in the letter writer. These are oversights that just shouldn't be there. Details.

It would be nice if each "subheading" such as "ORDERED", "PRESCRIBED THIS TIME" Would be BOLDED to aid in picking them out of the jumble that the PLAN becomes. I'd also like the ICD codes associated with the ordered test to be included with the orders recorded in the note.
You may find this hard to believe, but my staff find themselves reprinting lab and radiology orders for patients who SWEAR I never gave them the order. They then have to ask me what diagnosis code to use since it doesn't record in the note.

And, billl, it would be even better if the diagnosis given that day was cough and when you ordered CXR, the diagnosis given would be cough and not:

Cough
Eczema
Diarrhea

Sometimes, there can be twenty or more diagnoses, and I have to highlight and delete all of them and then type in the ICD-9 code manually.

THE ABILITY TO CHOOSE BOLD TYPE:

A Lot of Work for Small Gain?

Data Organization

When you have a large collection of data, like a patient health record, it is good to have options for separating separate sets of data for easy review.

In these days of the ubiquitous Microsoft Word, we have all gotten spoiled to having the ability to set important information apart by the judicious use of bold print, italics and bullets (not to mention auto-numbering, which would be on *my* wish list!).

I understand Vinny's point that it would be difficult to make this change, but this option is something that consumers have grown to expect. At some point, the non-programmer will be trying to organize some information, and he will *NOT* say "Hmmm... I guess it would be too hard to make this a rich text box."

"Gee Whiz! This is amazing!" will become "Crud! I can't even type in bold print!"

Public Perception

Furthermore, there are a lot of physicians, shopping for EMRs, for whom public perception are important commodities. They would like the ability to make their letters and clinic notes as organized and professional-looking as possible.

They look at the printed output of a "big dog" EMR, and they say, "That fits my image" and it's an emotional response that influences their decision about which EMR to buy.

The addition of bold print, etc., can allow the image-minded physician to create templates that are every bit as professional-looking as those of the "big dogs."

I agree completely with Brian. Logician over does it with five page progress notes which are ONLY designed to cover EVERY base of medicolegal documentation and reimbursement. While that is all and good it defeats the purpose of good charting.

But, I would hope that one day, Jon could sit down for an entire month and look at formatting.

Pretty much the only thing that formats well on a consistent basis is the scripts. The progress notes in general leave a LOT to be desired. The letters are horrible, and I can't even imagine they could be worse until I open an HTML saved version which is. I never know how far down my signature will be, and the letter starts near the top no matter how long the letter is. And, it is very frustrating that once you print the letter it is gone, and you can not look at it again in the print screen. It would be helpful if one could edit the letter after it is brought up into the print screen.

We use tables for things such as ROS, but there is no way to use it as a template and enter it so it lines up. These are just little things, but as Brian says, they make a big difference. I would think that at the EMR conferences, potential buyers would want to see the outcome of what the note looks like. A well-formatted note, with bolded headings, etc. would go a long way toward wowing that buyer.

Formatting is definitely an issue. With the letters, if they could just save it as a text file instead of .html we could at least correct errors noticed on the print-out without starting all over again. I guess RTF would be fine. No need to pay a huge fee to license .doc formatting.

Some formatting in the on-screen progress notes would help too. One of our problems with the Instant Medial History interface is that the lack of formatting can make it difficult to notice certain issues in the output. Its very clear on the printed output, but not so clear on the imported version.

Oh, we've started experimenting with IMH again now that the new website is up. I'll let you know how it goes.

Perhaps they could use OpenOffice for the letter writer?

Wayne,

Tell me how it goes with IMH. I just find it way too difficult to set up customer templates. I only need ten questions for headaches for peds and not 50. And, on well childs, it does a great job, but it puts too many things in social history that I can't have in every note. Maybe, it would be a good idea to have an option to delete all with CTRL - N or am I missing something. Guess I could also delete manually.

On the OpenOffice, that's a great idea. I have thought about Word, but I don't know if the proprietary issues would not less us go there. Then again, I am not sure if we could auto link to Open Office either. Maybe it could be an added feature with monthly or annual subscription.

I thought maybe Jon could use OpenOffice for a low, low, low, low license fee. Its open source, so I'm thinking DIRT LOW (ooooh, the F word maybe. 4 letters. GET YOUR MIND OUT THE GUTTER! Ends in E.)

Well, IMH has its plussess (spelling, but hey I'm enjoying champaign right now) and minuses. Someone completed it for a Travel Advice visit and it asked a some extraneous things like "Why did you pick American Airlines?" "What do you think about the price of your ticket?" "Some questions about airline security." Now,even I, a great Instant Medical History Troublemaker(I advocate it ALOT)admit that this CHITT shouldn't be in there. I sent an email asking them to make it stop asking these questions.

4 patients completed it today. I'll have to ask Vicky (Alice to anyone but me and our other 2 siblings) about the other visits.