Home Forums Discussions General Discussion copy chart

I did a quick search and couldn't find how to copy a chart from the EHR when a patient transfers to another provider-- is there a preferred way in which to do this. Most of the time it will be out of AC into another system for me. Thanks in advance.

I simply do Past Encounters --> Progress notes only + Immunization sheet. Of course I don't use II, and for the few I have in II, I just don't send.

I send the ones I have externally.

Bert,

What do you mean by ll? And do you print to paper or can you electronically send to another provider? Thank you for your quick response.

To copy the chart, go to the summary tab and in the lower R hand corner is "Reports and Resources" section where you should check the "Formal health Record" box {central upper, not in blue}

This will open a new box with the title of "HIPAA Alert" and you put in the relevant information about the release. It will give you the option of what you would like to copy.
Most of the chart opens in one window but if you copy import items, they will open in their own window. I will sometimes use a program called PDF redirect to collate all the files into one.

One page that opens is a summary of what has been copied.

Once all of this has been coalesced, we then will print it to fax whereever it needs to go, or you could burn it to disk if you like.

Overall it does not take more than a few minutes. The time to fax is the bigger consideration.

II=imported items. Like labs or other faxes received from an office or lab are typically placed in imported items. Bert uses File Assistant Pro. I use a combination of II and Windows explorer.

There's a variety of ways to send patient's charts. You can use UpDox's portal/faxing, a fax server, or encrypted email. All the aforementioned methods avoid printing paper. You can use regular email, but the email should be encrypted before it's sent out. Then decrypted at the recipient site. This often involves both parties having a pre-shared key. There's a lot of people that still don't know how to open a .zip file so...fax has been the main thing for us. I'm working on getting Exchange Hosted Encryption for us. The only service that doesn't require users to have some pre-existing agreement/password/software are good ol' fax machines and encrypted email. One of the reasons fax has been around so long.

Bert, Wendell, Sandeep--

Thanks to you guys--I am stumbling along with this EHR stuff, and it's definitely a lot less intimidating with your help!!!!
I get a bit frustrated when the stuff I use to do without any thought requires thought--

I still prefer printing to fax only the progress notes. But, that does leave the II. I am spoiled because I can print 500MB of "II" in about one minute and all separate, e.g. H & P, Labs, etc. so when I combine them, I burn everything to a CD.

Bert,
How do you print 500 MB of ll in one minute--I am sure you have said this multiple times but I haven't gotten it yet.

Bert,

I think I remember-- the eSata imaging stuff--

Jimmie,
AC gives you some choices of how to copy a chart, as it does with many processes. The choices can make this seem more daunting than it really is; once you choose your procedure, it is quick and easy.
There are two main decisions to make before copying, and the answers may vary from chart-to-chart.
The first is what you want to copy, and the second is how you want to send the record.
Wendell's approach is the "official" way and has some advantages. It will open a checklist that allows you to choose what you want to send. On the other hand, if you just want to send the encounters you created, you can use Bert's method and print them from the past encounters screen.
In either case, the other issue is the imported items (II). You can argue that these are "outside items" and need not be sent, or you might choose to send them. There are several ways to do so. If there are just a few, you can print them (to paper, to a CD, or to a fax program). If there are many, I think it makes the most sense to copy them electronically to a CD. That is most easily accomplished by navigating to the II folder on the server. It will contain a series of numbered folders. The numbers match the patient ID in AC. Find the folder and copy it to the CD (or copy the contents to Updox, for example).

The next question is how to transmit the chart. We almost never print it on paper. Small to medium ones are faxed and really big ones are put on a CD. Time of faxing is not an issue: drop them in Updox (or "print" to Updox) and they just go.
I suspect that what Bert is talking about is "virtual" printing (not creating a lot of paper, but a 500 MB electronic file).

Jon, thanks --and I PM'ed you the other day about our fine feathered friend.

Gigabit network+good client machines (SSDs+i7-2600K SandyBridge Processors.) Gigabit can transfer files at speeds of up to 125 MB/s off the server and the processor (which is better than most peoples' severs) can combine them with no trouble. Then, burn them to a disc. Last part is probably the longest.

Thanks Sandeep and Jon.

I have probably said this 100 times, but Jon's post brought it up again. The reason we send progress notes and immunization record only is we do NOT send the messages. Of course, it is part of our record we keep and can help when I get a message from my MA saying that Baby Boy Smith has a fever of 105 and a rash, and I write back saying to make them come in or go to the ED, and they do nothing. That is good documentation. But, we sometimes make comments that we would call venting that you wouldn't want another doctor or parent to read.

We sort of refer to these as "work product" which lawyers have and are not discoverable unless a judge says they aren't WP.

It is interesting, because if you send 50 pages and the immunization record NO office will ever call you on it. So Jon is correct that if you didn't send the II, you would probably never hear about it.

Thank God for Firefox and Chrome. I know this has nothing to do with this thread, but I didn't want to start an entirely new thread, and I had to get it off my chest. I.E. drives me crazy.

Bert,

I don't know what chrome is but i love firefox

and also thanks to Sandeep as well, and good to know about the messaging--stuff i didn't even think of that--and i hate ie too

Glad to hear there are other Firefox (FF) fans out there. All I hear is about Chrome nowadays. Google Chrome is google's web browser. There are 3 main web browsers: Internet Explorer, Mozilla Firefox, and Google Chrome. (Opera and Safari combined probably make up less than 10% of total usage.) Although I'm a FF fan, I'm not going to lie that Chrome is pretty darn fast and pretty easy to use. With an SSD, it's hard to remember how long FF takes to load on a normal drive. I have about 20 add-ons/extensions that I love in FF. My favorite add-on is probably Adblock plus which even blocks ads on youtube. The chrome version of adblock isn't all that good. Some other useful addons are NoScript, Download Statusbar, DownThemAll to name a few.

One really cool thing about Firefox (not sure about Chrome) and definitely not with I.E. is that it does spell check on here. I don't mean after where you run a spellchecker, but it will put a little red squiggly line under a misspelled word. It isn't always the most accurate. Probably > 95%.

I also like the way it updates every three or four days. You don't have one major upgrade that adds a gazillion things like one browser I know. Can't think of the name. I do know that there are many times that you can't do something with I.E.9 but you can with 8 or you can't with 8 but you can with 9. I do keep the thing about since there are some things Microsoft will only let you use such as remote support and our connection to the hospital requires the "security" of I.E.

Finally, I like it when Firefox crashes and has a bit of difficulty finding a site you were on (or something like that), and it says, "This is embarrassing....."

I go back and forth between Chrome and FF. Chrome is faster, Firefox seems to work smoother. Occasionally I use IE as well, but the others are better.

Speed rules, this I probably am predominately on Chrome.

With an SSD, the speed differences are hard to notice. I rarely use chrome or IE. Use IE Tab in FF sometimes though, another great add-on.

Also, looks like Firefox 12 just got released too. It fixes some UAC issues.

Thanks for all your help, I was able to electronically fax my first chart to another provider and it was less painful than I thought with all the great tips!!!!

Still think that FF wins over Chrome simply because of spell check. Unless Chrome does spell check.

Congrats jimmie.

Chrome does do spell check, but FF wins for add-ons.

https://support.google.com/chrome/bin/answer.py?hl=en&answer=95604

Sandeep--thanks for the chrome link--my vote is for FF bekawse i nevur mispel

I run without many add ons.
All are better than IE, but IE 9 is trying to catch up. Still slower.

In my experience, IE9 is fast, but it's just not secure. The vast majority of exploits are targeted at IE because it's integrated with the Operating System.

But FF does not seem to play nicely with AVG. Hope that changes soon.

I stopped using AVG after version 7 or 8. I just use Microsoft Security Essentials. AVG Personal can't be used for commercial use. Microsoft Security Essentials on the other hand can be used on up to 10 computers for commercial use.

I have FF and AVG and have had no issues.
Our hospital website is compatible only with IE or I would NEVER use it. I hate it.

I guess while we are all putting our favorites out there... Chrome and Microsoft Security Essentials.

Just as an update from a relatively new AC user--

Just a few thoughts on the whole concept of copying charts, and most of the seasoned users have come to realize this a long time ago, but I have to say copying charts electronically as compared to having your staff pull the paper chart has many advantages as I just learned.
First and foremost is utilization of staff, paper costs and the time involved dissipates with doing it electronically. I do the work and decide what i want copied and how i want it copied or sent--many more options and much easier to carry out and can be done immediately. The cost is minimal.
Now that I am about 6 months into integrating AC in my practice, continue to be amazed on a daily level the practical improvements of efficiency running the office. once again thanks for all the help.