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#79748 04/26/2024 11:45 PM
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I am seeking help from the AC community. I know several users here have been here for a very long time.

I was a user of AC shortly after it was first released many years ago, when I was in private practice. It was a really great find, and even if imperfect was extremely useful and user friendly. I have since moved to practice in a public hospital on a remote island, and we have an EHR (best unnamed) that has been annoying on a good day, but recently has developed an issue that directly impact patient safety.

Our EHR interfaces with NewCrop Screens, as did AC. However, the last couple of months, either our EHR or NewCrop or the interface has been randomly deleting medications from the active medication list. Our patients are not sophisticated, and often are not clear what they are taking even with out best efforts to do medication reconciliations. Thus, we can no longer trust our notes to reflect what medications a patient is taking, and our patients may not know.

My distant recollection of AC was that shortly after electronic prescribing was implemented that there was a button or link that allowed use to bypass AC and go directly to NewCrop Screens. I rarely used it since NCS was so cumbersome, but at least it was accurate.

Is that capability still active? Any words of wisdom how it might be activated? At least that would give us somewhere where an accurate medication list might be found.

Thanks to all.


David Grauman MD
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Known Newcrop /AC problem. ChrisFNP has track this some. I've seen it with refill requests on certain meds but not all. Amloidpin comes to mind.
Some interaction between a refill request then causes the med to inactivate.

Agree this bug needs to be fixed. This is far more important than any new feature.


Larry
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Hey, David. Always good to hear from you, even when it is with disturbing news like this.

We can access "the NewCrop screens" through - but semi-independent from - AC. I am not sure how that helps you since the process is probably different for your EMR. You might reach out to the makers of that (unnamed) EMR and see if they have a comparable capability.


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JBS #79752 04/29/2024 9:00 AM
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Exactly the same issue I have found in AC. Beagle is correct, there is some issue with the electronic refill and moving medications from the active list to inactive. You have to hunt back in the notes to see when or if the medication in question was actually inactivated. One trick I have found is the prescribing window now has a " Drug History" tab. You can click this and request history to see what was recently filled by the pharmacy. This has helped us with reconciling medications. Hope this helps.

PS: thanks for coming here and asking about it, seems like it is a New Crop issue and not AC, hopefully with version 12 moving away from New Crop our issues will improve

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Thanks, Chris

It is useful to know that other EHR's have a similar problem. I have used our PDMP program that will look at all Rx refills from local pharmacies, but we have a lot of non-compliance so that won't really help tell me what a patient is supposed to be taking. Medications now take up 1/3 to 1/2 of the visit time. Major issue. Thanks for the support.

Dave


David Grauman MD
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Woah, after all our gripes wtih NewCrop it's finally gonna happen?! Ditch them for whom?

Hope the transition bugs get worked out in beta as prescribing function is paramount to EHR workflow.


Larry
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I am on an older version of AC, and discovered a similar problem.
Medications renewed based on pharmacy requests did not populate accurately to my med list.
Since then, I have not renewed medications from the pharmacy request/refill screen.
Instead, I go to my med list and renew meds from that.
I then go back to the request/refill screen and deny the meds on the refill requests, indicating that i did so already.
I have found that it leaves me with a more reliable med list.
I plan to continue doing that until sometime after I upgrade to a newer version of AC.
Hope that helps.
ACZ


Anthony (Ton) Zwaan
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ACZ #79775 05/04/2024 6:27 PM
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Thank you all. Misery loves company. I will see if it is possible for our IT to arrange access to NewCrop independent of the EHR. If it makes you feel any better, our problem is actually worse. Portions of the med list, and sometimes the entire med list will be discontinued just by opening the chart. I now have to go back to my last note and recreate the entire list in the prescribing section from the list I had include in the note. (As an aside, I have habitually put the med list in the note twice; once at the start of the visit, to tell me where I started, and once at the end to show what changes I made. Our EHR does not have the capability of tracking prescribing history). Sometimes, even then, the list will be deleted while I am still active in the note. Med reconciliation now takes me at least half of the visit.


David Grauman MD
Department of Medicine
Commonwealth Health Center
Saipan, Northern Mariana Islands

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