Home Forums Discussions General Discussion Incoming Faxes to AC - Suggestions?

Here's a transcript.

http://snltranscripts.jt.org/91/91grichmeister.phtml

Not sure if that's the first one, but it would be an early one anyway.

Good luck on finding a clip on YouTube. SNL's legal department scours YouTube, flinging lawsuits at anyone who dares to post a clip.

Here's a bit of SNL trivia. Chevy Chase, who used to write for the Smothers Brother's Comedy Hour, was hired as head writer for SNL. He and Lorne Michaels became good buddies and, because Chase really wanted to act, Michaels cast him preferrentially in the "Weekend Update" segment and, well, you know the rest of the story.

Leslie

Ya know,
All this carrying on about e-Rx's and the government wanting it so bad, meanwhile they let the private sector create but another parasitic drain for our practices. If the collective "they" want it so bad, then why don't "they" be and pay for the centralized clearing place for all this "E" Rx stuf to go to, and then our vendors can write to one single standard that shouldn't cost the providers anything to sign on for. Now we have to pay for the privilage of getting on board for the next mandate that the talking heads want?

I am sick and tired of all the parasitic drains placed on healthcare providers.... This technology, these services, clearinghouse gets a little piece, answering services, various software vendors, send the claim 5 times and fighting all the way, can't charge or get paid for half of the things you actually do, billing companies or software and staff to do the claims (sorry Donna) increases in utilities and malpractice insurance, increased cost of supplies

It's time for everyone to either put up or shut up.....

Leslie,
I just went to the Brother link you posted for the 8860DN which is a great looking machine that I had been thinking about for quite some time and I have reviewed this before, but again today I re-read the manual about recieving PC Faxes and the manual says that it can recieve in either .tif or .max type files (anyone know what .max files are???).

So I guess my question is exactly how and what are you doing to convert these .tif's into pdf's and how easy or how much of a pain in the butt is whatever you are doing? Is this an easy to perform extra step with the included software or something? Once I can understand how you have dealt with this issue and I feel that it would work for us here, then I guess it is on to getting one for our place.

I just got our scansnap but haven't had the opportunity to install or play with it yet.... I'm so excited to get started. Bye-bye paper mess and lost folders!!!

Thanks much...
Paul

Paul,

A .max file is a file created by PaperPort or Omnipage and is an image file. It isn't used much and if you do not have either software, you need a .max image viewer or you have to convert it to a different file.

I think the only way to tell is to call Brother and ask. I can't imagine a fax machine of that caliber not faxing to a .pdf.

Paul,
I sent you a private message regarding this but the Brother will easily duplicate the fax into a PDF (JPEG, BITMAP and other) formats.

Leslie

Leslie,
Thanks got your PM and sent you a few more questions. Perhaps at some point we should post all that we have exchanged. Some others might find it useful too... Thanks again and have a great night...
Paul

any more ideas on this?

i'm using a setup similar to leslie's--a brother mfc that can handle fax to pc (albeit in tiff format).

i think what will allow this paperless route to be time effective is a good viewer/editing that can edit multiple .tiff (in my case, pdf's for others) quickly, including adding annotations as well as cutting pages or irrelevant areas (which would save not only database size, but also how much digging around needed if u need to pull the info again), and being able to flip thru different .tiff files quickly.

actually, i would really like a program like MS picture and fax viewer but with ability to delete unnecessary pages and add custom annotations (ie. stamps). i tried paperport, and i like how u can edit things quickly, but u can't delete individual pages. i'm also considering an OCR (pic to txt) solution to put into AC as an addenum, but i'll need more accuracy before i can rely on that...will keep looking for now..

Paperport can delete pages but the process is not intuitive. Going from memory, you need to first have it in PDF format then use the page sorter function.

Paperport easily deletes pages. Simply click on the file, click "unstack" and then delete the unwanted pages. This is done on the desktop. You can then restack the pages and move them where you want. Paperport also easily converts document to pdf format. Right click on the file, click on "convert to pdf" and voila!. I generally convert multiple documents at the same time. Click "select all", right click "convert to pdf" then delete the tiff files which are still highlighted. Easy.

Leslie

As an example as to how I further use Paperport...I review everything that comes in, take care of the refills myself and fax them back and then update them on the AC meds window. I pretty well know if my patients need a follow up for that medicine or I can easily check in AC when they had their last visit. If needed I can either put the refill request with a message to schedule the patient for a follow-up in one of the employees' folders (see below) or I then move the named refill into a Paperport folder I call "Refills". I have 2 subfolders here, one for the previous month and one for the current month. If a pharmacy sends a second request I can tell them we already sent it, find the one in the subfolder and fax it back. Each new month I delete the oldest month's folder as I see no benefit to keeping these any longer.
All reports, labs, letters I also handle. Upon reviewing a lab or xray I highlight important passages, put my signature stamp and date and any comments I might have, such as "Please schedule additional views of the right breast" or "Notify patient" and then place the document in one of the employees own Paperport folder (they each have their own). Throughout the day, the ladies check their folders, take care of the things I have requested on each document, place a comment such as "scheduled for 7/8/08 at Priority Radiology. Patient notified",initial and date the document and then move it into either a Paperport folder called "Physician to sign off" or "Ready to import" depending on whether or not the document again needs my review. If it is in my folder, I review it again, add further comments if needed and, if not, I move it to the "Ready to import" folder and from there it is moved into AC.

This is working very well for us. I actually like it much better than the Adobe Acrobat and the program was included with my Brother MFC.

Leslie

I know very little, well nothing, about Paperport. It sounds like a great program. I am inclined to agree with both Eric and Leslie as they use it.

What I do know is that if you want to do EVERYTHING with pdfs it is almost imperative that you use Adobe Acrobat. Unfortunately, it is a rather bloated expensive program, albeit you get two licenses for the $325 or so it costs. Again, Paperport can probably do a lot for less money and maybe even more.

I think like anything you have to list all of the features you have to have, all the features you would like to have and all those you don't and then compare products as to how they will meet your needs.

Again, I know nothing of Paperport. I do know that using Adobe, by the time I see the document, my staff has opened it, named it, moved the pages in the right orientatation, deleted pages and files they felt comfortable deleting and added sticky notes and stamps to the pages saying things like Records sent on such and such a date.

I know of four methods (I am sure there are more) for importing and dealing with documents:

1. Leslie's method
2. The normal method
3. UpDox
4. FAP

I would be inclined to say that of the "normal" type methods, Leslie's method is by far and way the best. I would have never thought of it. Basically, (correct me if I am wrong Leslie) she does her sorting PRIOR to having her staff import them. This makes her signing of the documents easy because she does them all at one time or from a room, and her staff can assume they are seen and ready PRIOR to entering the import jungle of AC. All in all, I would call it the number one method.

In an entirely different method, FAP is a close second and is completely different in that the files never get into AC. Try to remember that with the import method, they never get into AC either. They just reside in subfolders in a folder called ImportedItems. These are linked to patients via an ImportItems database.

The normal method does not get my vote.

UpDox can be a great way if you can afford the monthly fee and it has a moderately steep learning curve.

Bert,

You are correct. I see everything and it is acted upon before it is imported into AC. I actually even do a lot of the importing at the time I review the document, if it does not require any further actions. I can do this from any of the computers in the office or from home using Logmein. And, if I import it, I can have it automatically signed off by me at the time of importing so I don't bog my AC inbox down with a lot of things needing my signature. If I am busy and do not have time to do the importing I simply move the document to the "Ready to Import" folder in Paperport and anyone can then import them when they get a few minutes, just as they would do the paper filing. I can easily move the documents from Paperport to any number of other programs or functions...fax, print, to Word, to Quicken, to email. It works very much like UPDox except it does not directly link to the patient database of AC. That would be a tremendous feature if it would (for free :)) I was out of the office yesterday and using Logmein, and spending just a few minutes online at home, all of the faxes, letters, junk, refills are already taken care of. Things needing doing have been moved into the girls' folders and will be there waiting for them Monday. I use this way more than the email feature of AC. I looked at Acrobat and, except for the security signing feature, I see no advantages to this over Paperport. Also, since the CD came with the printer, there were no limitations on how many computers I could load it on.
Also, if the document has already been imported into AC and I want to email it to the patient, I can "print" it back to the Paperport desktop (by choosing that in my printer options) and then email it from there as an attachment to the patient (or anywhere else). Very useful program.

Leslie

thanks all for the suggestions--

leslie-quick ?-going back to deleting individual pages, it seems like the file has to be either .max or .pdf format, but i think if your fax machine is like mine, it only saves onto comp a .max or .tiff format. do u use the .max, edit, then save as .pdf, or do you convert it all to .pdf before manipulating?

All my faxes come in as a .tiff. I highlight the file (or go to the toolbar and "select all") right click, and see an option "duplicate as a .pdf". I click this and then see the new pdf file copied onto the Paperport desktop. The .tiff files are all still highlighted and I can quickly click "delete" and only the pdfs remain. You can tell if a file has multiple pages as the upper right corner is "dog-eared". If you highlight that file an option appears on the toolbar to "unstack" which it does one page at a time ( you have to click this multiple times for multiple pages. ) One can then see the blank or cover pages and delete them. I then double click on the thumbnail files which brings them up in the Reader/editing window. I markup the documents here, save and move them into whatever folder they belong. They are saved as pdfs.

Leslie

@ Leslie and dj: I feel a little bad, because I am a Brother fan although I have never used them. I still find it hard to believe that it came in as a pdf. PDF is so worldwide you would think all faxes could come in that way. Just seems like an added step.

The biggest problem with AC and the imports is it requires an Access connection to correlate with the patients. If there were a way to have each patient automatically connect to the folder itself, it would be simple to have FAP dump everything into those folders and vice versa. Maybe with SQL it will be different.

I think Ed is already working on a way to have them work together. Of course, the code would be nice. Or an SDK. Combining FAP with AC would blow away UpDox. Just one click, and you're done. Plus, it's nice to have the importers deleting the unneeded pages and the duplicates. Remember everything in FAP is logged, nothing deleted is really deleted and everything in and out of the fax machine is archived. So it is pretty much idiot proof.

Leslie, you should be happy I gave your method 5 stars. Of course, FAP is 5 stars as well.

I can tell you Special Ed is out of control on programming and given SDK or code status could not only make 3rd party programs but also incorporated programs.

Our next project (although we have to keep debugging) is to make a standalone instant medical history, much simpler than the expensive version and customizable with branch logic. The branch logic is the hard part. So, you would be able to have a patient come in with high blood pressure or back pain and have your own set of history questions so you would ask them all and have a full paragraph ready to put into the different subject areas.

Bert,
Believe me, I feel sincerely honored you ranked my method so highly. Your approval is head-swelling! If you can get FAP to automatically link to the AC database, I will convert faster than a donkey galloping to a handful of peppermints!

Leslie

We are working on it.

Leslie-was trying out PP, and it's very functional, but i don't think there's any hotkeys u can use--there's a free program i'm playing with called hotkeyp (http://www.sweb.cz/petr.lastovicka/others.html) that makes hotkeys, which would help in PP, i'm sure.

i also just found out a free (if you have MS office) proggie that can edit multipage tiffs, without having to break them apart first or convert to PDF, called MS office document imaging. it's good for individual files, but it doesn't have a folder/browser view. for that part, i'm trying out yet another program called xnview (http://www.xnview.com), which actually is a photo browsing program (great for photo enthusiasts), but it has tons of options so you can edit thumbnail sizes, labels, etc. it also handles multipage files, but like PP, u have to break apart first to edit individual pages, which is why i'm trying out MODI.

i'm also gonna see how the FAP works as well.

if FAP doesn't automatically link to the AC database, then how do you get imported items into AC? do you do it manually (ie. logon to AC, goto the patient's name, and then import it from there)?

I don't actually import items into Amazing Charts. My friend does, and he likes it. Leslie has a pretty good system. I would only do it the way Leslie does it.

Since I have FAP running on all computers, I can access any file on ANY patient without stopping to change patients in AC. My staff likes it, because they are only responsible for naming and categorizing the patient. Then, I can simply open the file and then import it. I find the entire import process in AC to be rather cumbersome.

i agree AC's import could be improved..i'm trying to figure out how, on my end, i'll be able to improve that (while waiting for Jon..). will keep tinkering..

Leslie and others with PaperPort (got version 11 from ebay yesterday):

first: How do you sign (?stamp?) pdfs?

second. Can u set a rule or default that nothing gets imported UNLESS document signed. if so how?

I worry that staff will scan and upload something and I will miss it. scary stuff.

thanks in advance.

The importing window automatically flags items being imported by non-provider users as requiring a sign-off. You won't see this when importing under your own account, as Amazing Charts assumes if you are the one importing, you know what you are importing.

When one of your staff imports an item other than a "non-medical" item (such as an insurance form), it will appear in your inbox and require you to sign off the item.

While this sounds good in practice, I have heard from a number of users how clunky the sign-off process can be. V4 (beta release this week?) addresses this with a process that should reduce the number of clicks to sign-off dramatically by opening each item directly and allowing comments, messaging to staff, and signing off on that same window.

Oncdoc,

First of all, I would love to address you by your real name.
In Paperport, after you open a document, on the left hand toolbar there is a rubber stamp icon. Right click it and it will give you the option of pulling in a .bmp signature that you have previously scanned and saved somewhere (preferably the network as you will need to do this on all stations you use). Then you can have this stamp defaulted to each time you click it...very easy.
There is no way I know to selectively allow staff to have access to the documents or what they can do with them. This is where having good staff and good control over them is vital, just as you do when they call in refills or call patients with results, etc. You have to trust that they are doing the right things.
I have a folder in Paperport called "Received Faxes" into which all faxed documents come. NO ONE, except me, moves documents from that folder to another. Staff can look at the documents to see if things have arrived but they cannot convert them to pdf nor mark them up in any way.
After I convert each to pdf and then review them, they go into other folders for action, for importation, or back to the pharmacy. Each staff member has their own Paperport folder and they check it frequently throughout the day. No document gets imported without my stamped signature. If the staff catches one I have not signed, they put it back into a paperport folder called "Physician to sign off". This folder also receives back documents which have been sent to staff for action and then have been acted upon (with documentation of such by the staff person). It also receives all the reports that come in the mail which are scanned. After I review the action (e.g. I asked the patient to be scheduled for MRI and the patient refused to schedule) the document is then sent to the folder "Ready to Import". From there, any staff member can move the document into AC.
I also have sub-folders in the "Ready to Import" folder. These hold the charts that we are in the process of scanning and importing. We scan into Scansnap and then "print" to Paperport, creating folders with the patient's name. Then throughout the day (or I can do it also after hours via Logmein) when anyone has a few minutes they can batch import from Paperport into AC and put the documents into their correct AC folders (of which I have many more than what it defaults to). On one hand it sounds like a very complex system but it really is not. It is pretty intuitive and basically mimics the paper handling system we used before.
Oh, and as far as importing wrong things or into wrong charts...it happens. Sometimes duplicates get imported. The staff simply edits the name of the document in AC to "DUPLICATE" with the subject heading "DELETE". Then when I open that chart and see that I can easily delete it at my convenience.
Sounds like the new AC version may reduce some of this back and forth...looking forward to it!

Leslie

Hi, Leslie my name is Steve.

Thanks for your response. Now, did you have to purchase multiple copies of paperport or will one copy work installed on all the computers.

we have a shared drive that we can all see. I am thinking to dump in all the scanned and faxed documents in there and setting up a system like yours.

Steve,
I did not purchase Paperport at all...it was free with my Brother copier. There were no license limits so it is loaded on every pc in my office (9). The incoming faxes and susequent folders are then shared across my network so that every station can pull them up and move them hither and yon as needed. Works great for me. Let me know how you make out.

Leslie

In general, I think it would be great if everyone chose to use their name in their auto signature at the end of his or her posts. It's much better to address the post to Paul than to Hockeyref.

I have a system very similar to Leslie's. One difference worth mentioning is instead of having the signature stamp, I review all the incoming documents on a tablet pc and actually sign the page with the stylus. I use a gateway m275 which I grabbed on ebay for around 400 dollars. This makes all the signatures look somewhat unique and nobody could stamp my sig without me knowing. I do not use the tablet to chart at point of care, just for paperport.

Adil,

That's pretty cool.

Adil,

I agree...good job.

Leslie

Looking forward to the beta testing.
Thanks for making such a sleek, adaptable product. I love the flexibility AC gives me, especially the templates.
As a doc just starting a practice the opportunity to use an excellent and affordable price. Vicki

Is it Christmas yet?

Vicki,

Sounds like you need a vacation I think we should start planning the next ACUC for the spring. Jon???

Leslie