Home Forums Discussions General Discussion Just venting here

Is anyone else just totally fed up with the letter writer? Like when you hit backspace to delete one letter, but it highlights the entire previous paragraph and deletes it?? Or like when you try to edit a doctors address and it inserts text with a completely different font??? Or like when you use try to highlight a sentence in a paragraph, and once you reach the end of the paragraph, it highlights the entire thing????

I have sent numerous messages to AC over the years describing these bugs in detail, and the only response I get is the sound of crickets chirping. I probably waste a good 5 minutes dealing with these issues every time I write my patient letters. It's really great that new updates will document whether I have determined the status of my patient's gender identity, but how about putting some of that coding effort into fixing this program so it functions properly??

Hi,

I think what you are experiencing is due to the grouping of content. When you insert text from a template then it's treated as a block of data but only if you backspace from the last character of the block. You should be able to backspace and edit other data fine. This is intentional as a means to save you from backspacing through the entire block if you inserted something by mistake. If we changed that everyone would complain they have to backspace the whole block of text. Same for the highlighting....you can highlight parts but once you hit that last character it assumes you're in block mode.

No, Chris, it is much more than that. I agree with Ed that this is an annoying weakness in AC.

When this letter writer was created it was such an improvement over the previous useless one, that we all just accepted it. In fact, it is still very primitive and a PITA to use.

It does NOT act like Word or any other simple word processing program. Deletions are partially based on grouping of content, but it goes beyond that. Inserted text is sometimes treated as a group, and sometimes not (whether it comes from a template or not). The various elements of a letter are inconsistently treated (sometimes they are treated as a block, and sometimes they are not); it is hard to learn which is which.

And I suppose there is some rhyme or reason to how the fonts appear, and perhaps there is a way to make them consistent. If so, I have not learned it. Most of my letters go out with at least two different fonts.

Does Harris currently have a process for reaching out to users to learn about how we use components like the letter writer, and to learn about our "stress points" in AC? I am sure that there are people here who would be happy to provide input.

In my opinion, a smooth, well-integrated word processing program is no longer an "add-on" for an EHR; it is a basic necessary component. Further, an extensive user guide should not be required to use it.

Jon,

I've stay abreast of our users dissatisfaction based on suggestions we receive through the enhancements option off the Help tab. I have 1000 suggestions since 2016 and only 14 are related to the LW, of those only 2 mention the text highlighting issue and those were from 2015. The others are asking for more data elements or an easier way to launch it from different places within AC.

It's the typical dilemma for us to decide on priorities...I concentrate on requests received since 2017, post AC 9.0, and of the 600 requests very few are duplicates, some are related such as "Orders Improvements". On rare occasions where i see more than 3-4 similar requests they get added to the list for consideration among other things.

Consider it duly noted and I've added a task to look into options to possibly improve the text manipulation and we'll look into the font inconsistencies as well. The roadmap for 2020 has already been established so it won't be considered for a while but at least it's on the list. We've been focused on regulatory changes (SCRIPT2017 for e-prescribing) for the past 6 months and as usually that doesn't leave much time to do things our users would prefer we be working on. 2020 should bring you enhancements we hope you find beneficial, a large number of them based on suggestions over the last 2 years and general gaps in functionality we've had for some time.

Hi Chris,

I agree the letter writer certainly could be improved. It is not really high on my priority list, but certainly would be nice to have.

My biggest concerns for Amazing Charts for the future just involve the basics, speed and reliability. We host Amazing Charts locally, and I certainly would like to continue to be able to do so.

Currently my biggest annoyances involve electronic prescribing of controlled substances. First, having to check the Maryland prescription drug monitoring program website before writing controlled prescriptions is time consuming. I understand there is a possibility that this might be able to be integrated into Amazing Charts, this would be wonderful. I believe Maryland has to approve this first, but if/when this is possible it would be a huge upgrade.

Secondly, I have just started electronic prescribing of controlled substances. It seems very awkward to have to do this through New Crop and when done through New Crop it does not appear to be recorded in Amazing Charts. It takes a separate step to do this.

Anything that could integrate EPCS into Amazing Charts, and remove some of the additional clicks, would be most helpful.

Over all, though, I suspect that you and the other developers have a largely thankless job, having to keep up with requirements and hearing nothing but complaints from users. I would like to thank you for all of your efforts, and say that, overall, you have done a great job!

Gene

Hi Gene,

Regarding PDMP with MD, we use a company called Appriss as our middleman to interface with all the states PDMP's. Every state with the exception of a handful share data with Appriss. MD may open up the relationship, they may not. Those few states require a custom interface just with them which is not viable for us to support. However we recently found a 3rd party who can to create a bridge with those outliers which may open this up for you ..we need to develop the interface with this new partner but we can't do that until sometime in 2020 but at least it's something to look forward to if MD won't share data with Appriss.

Regarding EPCS via NewCrop screens, we realize it's a pain and as such in 2020 we'll be adding the ability to prescribe all controlled substances from within AC without you needing to go to NewCrop. I don't have a specific date yet but we must do this as more and more states are mandating electronic e-rx of controlled substances so it's getting more difficult for everyone and will only get worse over time.

Regarding my thankless job, it certainly has its moments:-).......However kind comments such as yours are much appreciated. If you could only see the list of requested enhancements I receive you'd get a better appreciation of how difficult it is to keep 5000 independent physicians happy. We're a small company with limited Development resources and when the government stops dictating our lives, and yours, someday we'll finally have time to work on things that really matter.

My letter writter request is more data fields. Also the <meds> current medications field" in letter writter pulls the meds from the 2nd to last encounter. I print this out before each visit for patients to review and it's always 1 visit behind... frustrating.

Hi Larry..I just replicated this in my demo as far back as 9.4 so it looks like it's worked this way for a few years now. We'll get it corrected. Hard to believe it's always worked this way and no one has reported it, at least to me, and this is something I would have put on the list to fix had I been aware and it got routed through support or via the enhancements link...I read those every day just for things like this.

Thanks
Chris

@Chris
Great! My new fields request are phone #, language, race, preferred pharmacy.
Keep checking here for bugs and feature requests, it's better than beta testing and anonymous request boxes than we are unsure where they end up. Each post here likely has many others with the same silent opinion. Remember the messages thing was figured out here. We still await the final message fix!


@ everyone
We use the letter writer to print a check-in sheet for patients to review and correct. It has address, meds, allergies, new health screening done and depression/social needs screens that the feds require us to do. Very useful for us!

We should all be thankful that we have a direct 2-way communication with AC developers on a public forum. No other EMR has this. We can and do express our frustrations and requests here, but we should not forget to give AC credit where it's due!

The letter writer is certainly behind the times. It does work way better than the original version but moving from a Model T to a 1950's car would be a huge improvement. Only problem is it's 2019.
It still occasionally jumps back a letter when typing fast after it adds the template. It does delete in blocks rather than just backspacing as others have said.
We've become so used to it that it becomes a lower priority, but still a pain.

I find that Chris has been very responsive to user feedback and development is much better since his arrival. My only question is the "algorithm" or how he decides which things to implement.

As I have said in the past 1,000 users may want a larger default window for PMH, but only five users wanting to point out that if you type the word Kentucky anywhere in the note, it deletes that note and the two prior. I know, stupid analogy, but it just points out there are issues, recommendations and bugs that many may submit, but there are some issues which just have much more impact on the program. Like no ability to just close the prescription writer without it closing all the way. Sorry, about the hijack.

I will leave it for Jon here.

I understand exactly what you are referring to Bert; there is significant disparity between enhancements (new features or improved workflows) vs bugs (features that do not work as intended or are downright broken. Bugs that impact the majority will always be prioritized over enhancements. More inconspicuous bugs that results from uncommon workflows that are reported by few get a lesser priority but remain a bug to be fixed nonetheless if we ever get to a point where we run out of things to do. These go on a "Bug Watch" list and as they get reported by more clients move up the list in priority.

I have an early Christmas present for you Bert....In the next release we added an optional checkbox to the Prescription Print/Transmit screen....you can check it to return to the Prescribe screen after you either Transmit or click the X to close the window. Unchecked it works the way it does today, you pick your poison.

We've also improved they workflow around how you select the pharmacies and I'll provide more information on that with the release notes.

Wow, Christmas in November. Thanks Chris! That will be awesome. Also thanks for following the board.

@Chris,

I knew my new Batman signal would help, lol.

On a side note.... I would like to see when I add a new ICD10 code in the assessment to put it first above the ones there and not last in the column. I get tired of cut and paste all day moving ICD10 codes to the top positions in the column. If I'm putting a new ICD10 code on existing patient, its because they are new problems and should be coded first, not last. /end rant.

You have it now...Edit...My Preferences..User Preferences.....Notes...check the box to add new Diags to top of the list.

Glad I could help:-)

I never knew that! Thanks Chris

Gene

holy crap.... talk about not exploring the menus. thank you for this tip.

We added that back in 2016 in version 9..it was one of the most highly requested enhancements we had on file. Version 9 had a ton of new features so it was probably easy to get overlooked at the time in the release notes.

I typically do read them, but I definitely overlooked that one.

These are the type you can ask on the board. A lot of us would be aware of this. I was. But, I have a difficult time coming up with more than one diagnosis, so it doesn't apply to me, lol.

I mean, yeah, technically you did ask it here, lol.

OK, so Chris has allowed us to open up a floodgate here. But, I have always thought as I think many have thought that preferences or options are one of the most important parts of a program. There are many in the Admin section.

But, there are some good options and preferences located where Chris just mentioned. But, to find them, you have to go under:

Edit >> My preferences >> User preferences (and they are sort of batched together -- even when you get to My Preferences, it is mixed in with some password and template stuff).

Maybe if under File or Edit, it just had Preferences and this would take you to a preferences menu. There could be two sections. Those that affect only a particular user or computer, and those that affect all users, computers and applications. Those could only be changed by admins.

Just a thought.

Chris: "I knew that new batman avatar would spell trouble with Bert again." LOL