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I about to take the leep into Amazing Charts. Any suggestions about getting old patients into the system before their first visit?

One just enter them on the day they come in a few at a time so as not to get too crazy. You'll have most of them in there soon enough.

Two: Consider Bert's FAP and a ScanSnap for the document managment.

Good Luck

I enter the demographics before the appt. and then just use the paper chart for first visit - if you can type fast you can do basic entire office visit while in the room. Make a template for normal exam, normal full ROS. It will slow you down a bit for established patients, but well worth it. I did this long ago as I converted to using Amazing Charts and went paperless. I have used AC for years, went paperless 8/07 and now just enter pt. as they come in (can do full H&P during 15 minute exam).

I am an oddball on this topic (and many others )

Also, I have never made the transition to paperless.

I have chronic tendinitis in my wrists and can't type long. I also have thick old charts and patients with multi-system disease states.

So, I dictate everything with Dragon NaturallySpeaking.

When my patients come in, I have the nurse enter chief complaint and vitals. She then prints today's note as a draft (Ctrl-D) and clips it to the front of the paper chart. I use that page as a "scratch" sheet to take notes, and dictate from.

The first time I see them with Amazing Charts, they fill out a health questionnaire, even if they are established. I use that and then scan the old chart, if they have one, for pertinent other tidbits they may have omitted.

When they come back for a return visit, the nurse uses Ctrl-N for a new note, and again fills in the CC and the vitals, and prints a draft. *Now* it has their Past Medical Family and Social History, that was entered at the last visit. This makes a very nice reference while I'm taking notes.

The idea was to use this method until enough patients got into Amazing Charts and I could drop the paper chart, but the other problem was I had no room in my exam rooms for a PC and could never figure out how to do it (laptop, slate didn't work out).

I agree strongly with the incremental approach. It prepares you for the inevitable glitch, (your server goes down or whatever). You have lots of options, and can move as slow or as fast as you like. The more you do the faster you will get and the more you use templates, the better they will get.

I entered my complete ROS and PE as single paragraphs, (13.Cardio-mts Cardiovascular: Denies palpitations, tachycardia, heart murmur, irregular rhythms, chest pain, exertional dyspnea, cough cyanosis, ascites, edema, intermittant claudication, cold extremities, phlebitis, varicosities, postural or permanent skin color changes. Also denies hypertension, rheumatic fever, or taking medications for heart disease.)

But note that I began each system with a number. That forces Amazing Charts to list them in the correct order, instead of alphabetical order. And the number is a decimal because I have gone back and added additional pieces as needed. Finally it has my initials because we are three in this office and we share the templates, and delete what we don't like, keeping my initials on mine helps me to find my own.

Also I want to point out that you should prepare with the complete H&P but that is about all. Over 80% of the templates we have were created in real time with the patient in the room. And MOST of the other templates we tried to make in advance, just don't get used.

Finally I would suggest a template for the HPI that states: " This entry does not represent a patient encounter, but is a note saved for the purpose of entering data from the old paper chart". You have to save anything you put in the PMedHx or Soc or Fam by saving the "Note" and it saves time twice if you use a template. Make the note quicker and recognize it for what it is when you are looking in old notes.

All new patients and every patient then annually fills out a 4 page patient questionaire. This has the PMH, SH, FH, MEDs, ALLERGIES, IMMUNIZATIONS, etc. and 2 pages of Y/N ROS questions. The medical assistant takes this form, enters all of the info, less the ROS into the templates I made in AC before I ever enter the room. These templates pretty much match the questions on the form. When I come in I then use a template for either "New Patient" which basically says they are here to GET ESTABLISHED or the template for "COMPLETE EXAM". Both templates say I reviewed wih the patient the questionaire which is stored in the external chart. So, the ROS basically is already done by the patient. We elaborate on positives. I then have PE templates for
"COMPLETE EXAM MALE" and "COMPLETE EXAM FEMALE". I like having the patient fill out the ROS because then the next time they are in and say "I have been having blood in my urine for the last year...I told you about that" I can look back and see if they noted that on the questionaire, show them they did not and hopefully help cover my posterior. I think it also forces the patient to review their own medical history and to actually look at the medicines they are taking (unless the wife fills it out for the husband which is usually the case )

Leslie

Wow, five people and five different ways. That's what makes this board great. I won't let my staff enter them in until they get here. We have some software that Ed made to import the demographics from eMedware. (I know, everyone's sick of the softwar -- it's just that I say to Ed, damn I wish I could do 1, 2, or 3. Then he builds it over night. Of course, it's alpha).

Now one thing, dr Hoffman didn't mention (I think), was whether he already has patients already in some other software such as EMR or billing program. If you can get it into .csv or some type of universal format, you can import it fairly easily into the demographics in seconds. And, it's key to do it right off, because if you screw it up, you simply start over. If you have 3,000 patients exported into a .csv or txt or whatever, but you have already entered 100 by hand along with notes, etc., it will be a bit scarier process, although you can always back up the database. Adam did this and imported over 2000 patients in about thirty seconds.