Home Forums Discussions Problems Prescribing problems

Bert, it is a pain and extra time we don't have, they need to fix it! They still do not have Mounjaro in med list. It is on TikTok for weight loss but not in my EMR for prescribing to diabetics! Weird thing is pt's are asking about it for weight loss because they see it all over the internet with internet doctors prescribing for weight loss which is an off label use.

I guess I need to call New Crop......has anyone heard why the UOM list was changed?

Here is a new one, my MA who does not have prescribing privileges is now showing that she is sending in refills when she just clicks on a pt's medication, I checked the Admin settings and she is not set to be able to send in prescriptions.
I attached a screen shot of her setting.

Found the answer for why the UOM list was changed. I have attached a screen shot from the NCPDP website. I use a lot of the prefilled pens for diabetes all have different measurements of how many ml's are in a pen. To me, it would be better to say how many pens you need per month for those, most are 1 per week. The NCPDP says that a prefilled pen "term does not quantify a measurable size for dispense". 1 pen is 1 size not sure how that is difficult.........I think inhaler had the same descriptive problem listed

Can't prescribe anything at all? Happened yesterday with my NP in my office. I was having no problems (Version 11.2 in the cloud) but Carolyn couldn't send anything, kept getting an error message. She'd been dealing with this over the last week and a tech support guy gave her his personal cell phone number. She called him, left a message, a couple of hours later he said that he needed to reboot our remote server which he did at lunch. Then he told her it is a "system-wide problem."
For the life of me I don't get why tech support doesn't send out emails, bulletins to the paid subscribers about these issues. For her it was infrequent, then frequent, then total over a week.

OVER A WEEK??????? THAT WOULD KILL ME. Was she able to print and fax? How are you getting around it?

We have a similar issue with V11.2, So far they tell us that they don't knw the cause and are working on it. Deadly flaw. I suggest stay clear of 11.2 until they fix the bugs.
I thought they learned from past mistakes but apparently not. Very disappointed!

Thank You BOTH, I was looking forward to 11.2 fixing some of the prescribing issues not making them worse. Have either of you thought about rolling back ti 11.1.4?

You may be able to roll back online, but I don't think you can change the data tuner part and roll back if using a severe. This is where VMs come into play and setting checkpoints, but then you can only play with it and not use it daily as your production machine. Or use a completely separate VM if you can get it activated.

I am not sure they realize how hard it is to practice when you cannot prescribe or refill medicines. It has been such a pain. I have a physical server but if I could roll back to V11.1.4, I would.

Just put in ShoutChat that my NP couldn't Rx at all the last 2 days. Just a minute ago tech support said it doesn't affect MD's (didn't affect me), said it was a NewCrop problem (I thought we were done with them except for history) and are rebooting the cloud momentarily. Agree DO NOT upgrade to 11.2 until bugs are fixed IMHO.

Another problem. With 11.2 when you prescribe a controlled substance you must now put in the days' supply. I'm a psychiatrist with a large ADHD population and there's a nationwide shortage of Adderall (brand and generic) and it's a scavenger hunt like Paxlovid to find a pharmacy that has them. Yesterday a patient said the two biggies Walgreens and CVS didn't have any of the 10mg tabs and he found an independent. Since we'd already sent 90 to Walgreens, when we tried to represcribe to the independent, AC wouldn't allow it. We had to call the pharmacy and ask if they had 20mg tabs and since they did we changed to 20mg 1/2 tid instead of 10mg tid. I don't know what will happen to any controls if someone needs a vacation override.

Not true that it only affects NPs. My partner physician cannot write scripts. My staff also has issues looking up prescriptions and updating medicines.

Sorry to hear this bug also affects physicians. They fixed my NP's account but sadly said that "this fix is temporary" and that NewCrap is working to fix the software.

Electronic prescriptions not working (did not work all morning). We had to call in / fax.

Over 2 weeks since Mark Drabeck has been here. Months since Chris Conrad has checked in.

Would be nice to get some kind of up date as to what is going on with this update that was supposed to solve eRx problems when it came out last year.

What is frustrating at times is if you don't like Dish, you just call, cancel and go with DirectTV. No big deal. Even when you don't like your car or dealership, you trade in your car and lease or purchase a new one. I can't see anything more difficult than changing EMRs. Transferring data would be scary. I think if I did it, I would just start from scratch and use AC as my archive.

I think it's funny because every EMR benefits from new customers and those who are going to leave will end up leaving anyway. It just makes sense for all companies to work with other EMR companies to make the transition earlier. I am not considering changing. But...at times...

I know this one company who I looked at last year. They still send me emails five times a week on webinars and updates and bugs and stuff. Mostly education.

_________________

We have all talked about this before, but it would seem easy for Harris to come on and say, "Yes we have experienced everything that you are talking about. That is our main focus and we should have an up a complete fix by November 1.

Agree 100%. They do take you to the brink of walking away and I would jump the ship if I could! I don't mean to question the abilities of their development team but something has t change. Too many conflicts with Windows OS and other interfaces. Every time they work on improving something, it gets worse. I would cut them a slack if this was the first time. I don't know what to say when the staff expresses frustration and experiences embarrassment in front of the patient when AC crashes. My staff take calls from upset patients when prescriptions are not taken care of or the program crashes while they are looking up something. Electronic prescriptions were not working Saturday morning and was not ware until we started getting calls. Patient had to leave town and the pharmacy did not have the prescription that I thought I sent two hours ago. It is Deja Vu over and over again.

Hi Bert,

The trouble is that when you switch EMRS, you aren't just walking away from a car that you don't like and buying a different model.

You might as well expect GM, Volkswagen, and Toyota to spend billions working together so that their cars all use the same pistons, transmissions, and engine blocks in case you want to swap them into a competitor's vehicle.

Hell, even the spark plugs are different most of the time.

Interchangeable data or parts would be nice on incredibly complicated databases or automobiles . . .

But it's not gonna happen.

Cars and EMRs may do much the same thing, but each one was built from the ground up and therefore uses its own peculiar parts or data structures.

***

Think about Windows and Apple.

Christ, half the time an attempt to copy a photo from an iPhone to a PC for storage produces a mysterious 0-byte file.

And attempts to mass-copy photos mysteriously skip half the selected photos.

Complaints on the internet about this ridiculous problem stretch back to the crack of doom.

***

Which leads to something useful, as opposed to a mere rant on my part.

A few months ago, I gave up and bought the third program that I've paid for in nearly forty years.

It lets me copy files back and forth from iPhone to PC so I can synch the roughly one thousand books in my ever-growing library, copy my endless photos without losing my temper, and make real backups of an iPhone.

Much like JamesNT custom-extracting AC patient records as PDFs, someone had to write a whole program just to make simple file transfers work between two competing computer worlds.

If anyone is curious, the iPhone-x-Windows two-way transfer-program that made me happy is iMazing. Works like a charm.

For small transfers (yeah, some of you don't take thirty photos on a morning walk or keep a thousand books on your cell phone), the free version of SendAnyWhere works, too, and is very handy for printing iPhone reminder files as PDFs to a PC, where you can use a real keyboard to work on your notes.

(Aaargh! I wondered if I was boasting--really, a thousand books? A quick check shows 3,130 files in 174 sub-folders in my 8.8gb library folder. Things must have grown while I wasn't paying attention. This is embarrassing, but not as embarrassing as the number of photos and videos, which I don't have the courage to count.)

Cheers,

Carl Fogel

I get what you are saying, but I may need to clarify my statement. Back when things were really bad and I was considering changing EMRSs (keep in mind one of my goals before retirement has been to upgrade to an EMR online that formats better and has more bells and whistles. There are many EMRs that when you enter weight and height, it produces a nice tablet of weight before, weight now, weight changed, % loss or increase, conversion to pounds/ounces automatically, etc.

Don't get me wrong. For the price especially in the beginning and for pure documentation speed, AC is tough to beat. I won't comment on other things.

But, I digress. When I looked at say, Athena. They would say what EMR do you come from. And, if you say AC, they would say oh they are tough to work with in exchanging data. And, list others that area easier. This is just a hypothetical example that came up with others, but I use Athena here.

So, the spark plugs are indeed different. The amount of working together nicely isn't always the same.

Hi Bert,

To be fair, AC has a long development history, leading to a wide array of features.

In my experience, the less an EMR does, the easier it is to migrate its data.

So most well-developed EMRs offer migration, but the older and better the source, the more limited and difficult the migration.

Cheers,

Carl Fogel

I disagree. Strongly.

AC may be easy to use but its array of features is... not wide.

Meeting governmental requirements, and necessities posed by ancillary programs like Windows and NewCrop suck up nearly all of the development efforts.

Hi Jon,

What would you say are the top ten features implemented in three other EMRs that are missing from AC?

The specifics would probably interest many users on this board.

Cheers,

Carl Fogel

If you have decent bandwidth the changes from one window or page to the next is nearly instantaneous. The formatting is light years ahead. Some allow direct communication with the pharmacy so if they have Zoloft 50 mg, it shows up Zoloft 50 mg in the EMR. IT HAS A FACE SHEET FOR EVERY PATIENT. Medication reconciliation is more robust and automatic. While 11.2 is supposed to do the following, I have not used it yet: but many EMRs allow one to send three of one script at a time. The list goes on and on.

I talked with one physician group who was working with an EMR company that would make independent features for independent practices/customers. In testing, one could have support on withing one minute of asking via chat and one hour via email and nearly instantaneously by phone.

Hi Bert.

Which EMRs do you mean?

Board users would probably like specifics--a screen shot of the formatting, for example.

Cheers,

Carl Fogel

Carl,
It is tough to give a good answer because we each function in our particular silos and rarely get to see other docs working on their EMR, which is the only really good way to see that functionality. In addition, I am a GI specialist, so I have very different needs than the primary care docs.

Off the top of my head, here are a few. (And btw, AC is aware of these, as we have been asking for them, in some cases for a decade).

1. The ability to easily insert labs and other results into the body of the note.

2. Formatting options, as Bert mentions. The ability to make notes look like you want them to look.

3. Other EMR's have integrated portals for patient access and communication that are far more functional and well-integrated than Updox which has its benefits but is crudely duct-taped on to AC.

4. A more flexible and rigorous system to remind primary care providers of the long and growing list of recommendations/mandates required for patient care these days

5. A quick and reliable ERx component.

6. A letter writer that functions more like Word 2022 than Word 1998.


I can come up with more with a little thought. I am sure others can as well.

7. A way to deal with errors (e.g. hiding them or putting a line through them)

8. A legit way to print/send an entire chart

9. Allow users to create and set their own eRx "favorites"

10. Dropdown tab to see last 5 or 10 patients worked on

Hi Jon,

Thanks! Hope you get something on your list for Christmas!

Do any EMRs come to your mind that have already received most of these from Santa?

Cheers,

Carl Fogel

The last thing I want to do is to continue to compare AC with other EMRs and make them look bad. But, the majority of other EMRs have all of those and many more. It's just not even close.

Here is an example of just one of the EMR companies is doing. AC used to have annual conferences. But, this takes the annual conference to a whole new level.

https://www.charmhealth.com/charmalot/#home-target

The company name is Charmhealth, not Charmalot just to be clear.

Carl,
Let me respond this way... I see two choices: one is to break with AC and start over with a new EMR. If I were 40 or even 50, I would definitely investigate other options aggressively. I am well past that so I am not spending the time and energy (and heartbreak) to look closely at other choices.
Instead, I am sticking with AC. In that case, all I can do is what I have done for the past 12 years. That is to simultaneously try to live with AC and find work-arounds and work flows that deal with its shortcomings

AND

Periodically try to convince the company (AC/Pri-Med/Harris) to commit resources to product development. To pay attention to what users clamor for, and also to look for improvements that might pleasantly surprise us.

Despite the efforts of some at Harris - and I know some people are working hard - we have seen little progress on this front. I understand that mandates and requirements have sucked up a ton of energy in development, but the same is true for other programs that are much more feature-rich than AC.

Well my NP cannot prescribe again. Tech support had to kick everyone off, reboot our server. They admitted this random bug is AC's, not New Crop's fault. They said it is a problem/bug in version 11.2, are no longer upgrading people to that version (lucky you guys who didn't) and are having problems locating and fixing the bug. This is awful.

@Shrinkrap. Thanks for testing out 11.2 - I usually wait a few months before upgrading. Same goes for Windows -staying on 10 and apply updates about a week behind release.

New features are nice, but well-functioning non-crashing basic function is far more important. My feature request is better hi-res screen scaling. My eyes now prefer slightly larger crisp text which is hard to accomplish with AC.

We have been having issues with the script writer also. Nick from AC ran a script on the server and for now the problem resolved. We are keeping the fingers crossed and hoping this will be a permanent fix. Have had a tough month, not able to write scripts.

no problems yesterday, just getting started today, sorry you tried the 11.2 and having these problems Shrinkwrap, sounds like this should have been found in beta testing, still don't understand why they can't roll you back to 11.1.4. I thought with previous updates it could be rolled back.

Thanks for updating the Post and the shout box, seems like there is NO communication from AC!!!!!!!!!!!!!!

Tech support says rolling back to earlier version from 11.2 would wipe all data/progress notes/Rx/med changes since update.

Yikes, I don't think that was the case with the older version, sorry you are stuck with these issues and 11.2. I wonder how many AC users are having issues but are not members here on the board.

Yeah you can't go backwards. With VMs you can make check points and play with any new software or setups for a day.

The other answer is 100s.

Even with maximum caution and a VM, eRx is a really tough thing to check since you can't really send prescriptions from the sandbox set up.

And while Bert may be correct... we will probably never know the real answer. (my prediction is that AC will say that "a few people had problems").

AC will say that "a few people had problems"

You're optimistic,I don't figure we ill hear anything..........thus part of the problem

Woohoo, the new medication I have been complaining about is in the system.........it is only 4 months later

Any one else notice that when you put in each or kit , maybe others , in the UOM that when the prescription is printed there is an extra S on the end making it eachs or kits...........

Just saw this morning Pad turns into Pads