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Why not have all the SOAP components CC, HPI, ROS, Objective, Assessment all on one side, the others on the opposite side. Then as you hover the mouse over a section it expands to a area that is about 1-2 to paragraphs in length, and if you want to lock it in the open position you can do so with a mouse click. This can allow you to have more than one section open at a time for instance the HPI, and Medication list. Also the area that you can work with would be more practical than the sliver of space that is current. Then with the big box view, allow it to show the entire note. I would also eliminate or give option of turning off the Functional status section.

Or just bag the whole left side and have it run like the big box but allow all the components CC, HPI, ROS, Assessment, Plan to be seen at the same time.

Also allow to mouse click the labs results that can be added to note as an addendum.

Then later fix it so we can shift from a Soap note to a APSO note which is the most efficient way of documenting and relaying info.



Dru

It would be helpful when matching imported labs with patient if we can have the option of putting in the birth date to bring up list of potential matches. Believe it or not in my section of the country putting in the name is not an exact science. For instance many patients use different versions of their name with different services. What should be a quick and easy process can sometimes take 5 minutes and more than one computer accomplish.

Dru

Dru, you gotta ask for one thing at a time. And, you have to request via the EMR, although it is good to talk about it here. But, you are pretty much asking them to rewrite the entire progress note section.

[quote=]Then later fix it so we can shift from a Soap note to a APSO note which is the most efficient way of documenting and relaying info.[quote/]

Nothing has saved me more time than APSO. I open an ED note or History or Discharge from our hospital system because they are forced to use APSO, and I name it and import it. Don't have to read it, because I have no idea what they did. For me, it's horrible.

Now, with consultant notes it is different. I already know the subjective. I know the HPI. I pretty much know the exam and labs, etc. So, I don't need to read the SO. All I need is the down and dirty Assessment and Plan. I don't mind if they use SOAP, but I see the value in using APSO. But, for ED notes. Yuk! See the patient and see the diagnosis? The fun part is their Decision making lets you know how long the HPI is, because it is always bigger than the HPI on page two at the bottom. Because they dictate the HPI in the Decision Making or what they refer to as the Assessment/Decision Making. I have no idea why the patient went to the ED or what the labs are or what the exam was.

Just diagnosis:

Kawasaki disease

We have been working on a prototype for a revamped MRE very similar to what Dru describes....We bounced it off a few long term AC Providers and it was well received. It would be a massive undertaking. We have no plans currently to start development but it's on my mind.

While we're in the neighborhood here...What would you think about this concept?: http://thehealthcareblog.com/blog/2019/01/16/the-perfect-office-note-soap-apso-or-asoap/

Imagine This summary replacing the Subject area on the Past Encounters tab in AC?

I would love to see. But, please don't go to APSO. Please!

aSOAP makes perfect sense. Is it going to move the Assessment and Plan automatically.

What I will do is push for APSO as hard as I can. That will jinx it as none of my suggestions have even been integrated since I started as the first user or so back in the beginning.

Now, NEWCROP. I am on the advisory board. They listen to me.

I believe it would save time if we could delete multiple messages from the message window by highlighting with shift/Ctrl key and left mouse button then deleting. Rather than going to a new page and checking off the messages to delete. I know it ain't a big deal but it feels that my time is being chip away by seconds at every turn with this EMR. It is as if they designed the EMR to keep me on this for as long as possible. If that is the case then I suggest some commercials at the very least. Try to sell me something now that you have me on the program for extended amount of time. Lets make this profitable and get money exchanging hands.

Dru

Dru,

Have you seen or tried NextGen, Centricity, eMDs, Athena, eClinicalWorks and hundreds more. All of them are simply made for documentation. They are extremely slow. Extremely.

Amazing Charts is the fastest EMH I have ever seen. It is blazing fast. I just did another med check using NewCrop, et. al. using all of 45 seconds.

Of course, others are longer, but I don't see how you can find one faster. Some of the bulkier and much slower ones do produce a better note with more documentation (which is forced), but the free-style of AC makes it, by far, the quickest.

Dru,
You know you can delete multiple messages at the same time, right?

Can you explain more about what messages you are deleting. And, which category?

Bert:

Your right there are many more EMRs that are worse than AC. It may also be a fact that AC is one of the better ones out there. But in IMO that is a very low bar. The problem with AC is that for almost every job that needs to be executed you have to leave your current position and go to a different page. So instead of being a linear process where the flow of work appears to be progressing in a linear direction we need to jump in and out of pages to complete a task. I have seen a few EMR and they all suffer from this fall back. So I am guessing that this is inherent in many EMR especially if you are creating one by hodge podging a bunch of ideas through the course of time, and not engineering one from its inception. I believe this is what happened to AC. Even so the inherent problems can be mitigated by some creativity and ingenuity, and that's why I created this post. To see if we can brain storm ideas where we can get around these speed bumps that are inherent in the program.

So for deleting the messages problem. I am talking about those in the Inbox folder on the home page. You can't delete multiple messages from there. You have to go to the delete page and mark the boxs individually and then delete. I was thinking that it would be a better idea to be able to select the messages to be deleted directly from the home page "inbox folder", by using the mouse and/or the shift/CTRL key to high light or check off the messages simultaneously to be deleted, and then delete. So if you have 20 refill type messages. You could stack them together then high light them with the mouse/key and then delete. What you do now is delete one message then your given the option to delete multiples that then takes you to a delete page. Then you stack all the same messages together, then check off a box for each individual message to be deleted, then delete. Whats the difference. Minutes. not a lot but the whole program is littered with these speed bumps. Again its something that can't be changed, but can be mitigated. AC is not a bad program its just littered with many speed bumps. As a result it takes more effort and becomes the focus of the practice. A good EMR is one that runs almost in the back ground, requiring the least amount of effort and time. EMR programmers don't understand this. Because their focus is on their product, not on the fact that we don't want to spend any more time or effort on their product than needed. So they will produce a product that does many things but they don't care to realize that its going to take all day to do it.

Peace out

Dru

Dru and other physicians, I strongly encourage you guys to head to the meetups/ACUC. That kind of feedback is what they need to hear. I've been to a few of the meetings and I can tell you they are heading that direction of adding features and more add-on products.

AC has changed hands so many times, they seem to forget that their biggest selling point was that it was the easiest EHR to use that people didn't need training. Yet AC has plans to invest in more extended user training and other related services.

Not only the easiest, but in many ways, perhaps the most flexible.
After years of reading these forums, and working with the program -- not just me, but observing my partner and several other practices in town-- it becomes apparent that everyone uses it somewhat differently, and emphasizes certain features over the others.

From the point of view of one who receives a lot of hospital, ER and consultant reports, I can say that the reports that are generated by an old fashioned transcriptionist are best, from AC next best, and from Cerner and Epic are often so convoluted and verbose (with so much machine generated garbage) as to be almost useless. I hope that isn't the way AC plans to go with their "enhancements".

I believe that have text formatting abilities in the big box to include high lighting would be very helpful.

Hi Dru,

Years ago a group of these brought some of these up. BUT, it is good to have a new physician with a new set of ideas.

Just wanted to mention something in case you don't know. And, obviously, I wouldn't have made this forum if I didn't think it was good to have. It creates discussion and allows others to at times tell you why it wasn't done or agree or give you a workaround.

I just wanted to point out that if you really do want AC to look at a recommendation, you have a much better change if you go to the official location. Which is on the home screen at Help and then Recommendations. I would put them both places.

Thanks. Please let me know if you were aware of that. If not, maybe AC needs to make it more visible.