Provide ability to associate more than one referring provider to patient. We routinely have 3 or more as we are highly specialized. Real pain to keep track of who is to receive physician notes.

When using the letter writer & referring provider is selected, the letter SHOULD automatically pull the previously associated referring provider data into the letter.

Provide the option of pulling a fax cover sheet for the referring provider for the selected patient that includes providers data including their fax number.

Current methods are horrible. Requires you know who the referring provider is before opening the letter writer. You have to create a "letter" instead of a fax cover sheet. Then you have to look up provider so you can hand write the fax number on the cover sheet so you know where to fax. Horrible system in place for such a critical aspect of a specialized practice. What a waste of time.

Version 5 will allow you to add the referring provider to the patient’s demographics page. There will also be a place in the order screen to create referrals. We are working on revamping this process.


Claire

Thanks for the ray of hope. Glad to hear it is being revamped. My issue is not making referrals as we are typically the last ray of hope for children and adults with very difficult to diagnose issues. By the time the patient sees us, they will have many providers interested in the outcome so having up to 4 referring providers is great. Anyway to think about it is to have one referring provider and then a section of who should receive physician notes, which would automatically include the referring physician and then you can add multiple physicians from the Rolodex.

Then when you produce a note, you can simply select "those to receive" notes and the system would automatically produce a cover sheet for each contact as a fax coversheet or letter or Letter & Fax cover.

If you go from Help at the top of your Amazing Charts program there is a place to suggest improvements. Dr. Bertman and our development team really do look at this. I will be happy to also add it on my list of requested improvements. Thank you for your help in making Amazing Charts better.

Claire

Claire,

Thanks for your post and the info. With all due respect, though, it will take a lot to change the experience of many of us who have been using AC and been on the boards for awhile. We have used your suggestion. We have posted on the wish list. We have emailed. And, there are probably five to ten suggestions we give over and over and over and never SEEM to get looked at.

In fact, it is ironic that this is the first time I have seen anyone actually come on here and state we are going to try to do this or that.

Hello Bert,

I understand your frustration. All I can do is offer to present your requests to our development team at our next meeting. My email is Claire@amazingcharts.com.

Thank you for your patience
Claire

Thanks Claire,

I know in the past we have received some newsletters. One thing we have all mentioned is a quarterly newsletter that can talk about issues in health care --> maybe even link to Jon's magazine, then talk about AC, maybe even a testimonial from a new user, maybe even highlight a new or existing user and then talk about upcoming features as well as some ideas people have presented.

What are your thoughts on that? I know it means possibly adding one more employee.

A digital newsletter like this would be nice.
http://www.nxtbook.com/nxtbooks/aafp/fpm_20091112/#/0

Wow, that would be nice.

Claire,

I understand and have submitted suggestions via the Help section as you suggest. Nice simple tool. The issue from a user perspective is that tool is a black hole as nothing comes back to let you know the suggestion was heard and will/will not be acted upon. Also moving ideas off a discussion board prevents you, AC, from having a suggestion flushed out by end users. Think about how much better a suggestion would be if flushed out by end users? Your Use Cases would become cake. I understand the need to keep some or most of that process behind the curtain, but you may wish to select & invite certain users onto an advisory board which is different than beta testers. Do not limit it to just a few, but this dis-similar board of users could flush out suggestions and ideas in a forum type board which you (AC) could monitor & review.

I like your product and you may have thought all of this out. I only offer in a spirit of take what you want and leave the rest. In addition to managing and revamping medical practices I ran a custom software company, so I understand how frustrating the process can be. Also, everyone is a critic

Claire,

Another issue with the suggestion tool vs this board is that I have no idea if what I am suggesting has been kicked to death. With the board, I can search to see a) is there a work around, b) am I correctly using AC, c) I am not alone with running into an issue, d) the issue has been addressed ie selected to be revamped, heard but on hold for now. To advantage of the tool is that you get to see how important is it as the number of people reporting it will give you this heads up. Now if there was a way that the tool could provide the above, then you have a tool that provides the best of both worlds.

Thought of, users invited, users responded and not instituted.

The problem as I see it is the comparison between a small app and the closeness of its community to the end product and how a much larger application such as Microsoft Outlook works with its consumers.

In some ways, we as users forget that with an Outlook, we could create a user board and ask for changes till the cows come home, and we would hear nothing back until version 2003 changed to 2007. For instance, I have emailed Microsoft about something that drives me crazy: the fact that I can't change the Reading Pane in every section, e.g. Inbox, Outbox, etc. with one click but have to go to every section to do it. How, 10,000 Microsoft employees don't notice that as well is beyond me. But, that is a small thing.

But, with AC, we tend to go on the idea that we should be able to ask for changes constantly and have them acted on. And, maybe that is not possible.

But, the problem is I can understand why Microsoft can't act upon a simple request and AC may be able to. I have no idea if anyone is understanding what I am trying to express here.

I would think from AC's point of view, you would look at user feedback (if you could act upon it) in two or three sections.

For instance, I would LOVE to have kgs and lbs in two different columns. But, we peditaricians who need that are few and we can probably live without that. So, that would go in your things to think about in an upcoming version. But, you should have another section of HUGE things. This is where users get frustrated as AC moves forward in a direction that is necessary, e.g. CCHIT and PM, etc. Things like the letter writer. Things like the prescription writer. And, if I may speak for Leslie, the SEARCH FEATURE, which is not only not useable, it is dangerous.

I have not seen one user write on the board that if AC never changes the weight/mass VS section to kgs in one column and lbs in another, they would not use AC. In fact, maybe three of us have even brought it up. But, whether or not some think that Osler may be too negative (I don't think so -- hang in there Osler), you have verifiable proof that certain huge populations of users, e.g. specialists may not purchase AC due to its letter writer.

As a global moderator and I believe the user with the longest track record, I receive calls and emails from all over the nation. I have personally spoken with at least 50 physicians about AC on my own time about the merits of AC. As would be expected, I give it glowing marks and always encourage them to download the program. But, they ALL ask about the letter writer and, I am not able in good faith, to recommend it on that part.

While this post is not only about the letter writer, this is how serious I think some users find it. When looking at reasons why you are unable to pay attention to certain improvements and/or annoyances due to huge things you are working on such as:

CCHIT
Practice Management
Other government requirements
ePrescribing

I would actually change that list to say:

CCHIT
PM
Other government requirements
ePrescribing
Letter writer
Search function

MJK talks about an advisory board and I have had discussions with AC about this. But, here is an advisory board for AC:

I think I can speak for the ENTIRE AC nation when I say that the Letter Writer and the Search Function (or not function) are the two most important things for AC to look at.

When a physician sees a patient for an annual checkup, and diagnoses a new problem such as high cholesterol, he or she still looks back at the asthma and makes sure it is in check and being treated properly. I would think it would be the same with AC. Sure, moving forward on new projects must bring much more excitement than looking at what things are still lacking in Version 4, but try to remember that even when you add CCHIT certification and a PM, a new user will not know the difference between features and usability from version 1 to that of version 5.

I agree totally except that I would put the search function higher than letter writer.

The letter writer does work, although clunky.

The search function, an essential function for managing patients, does not.

I agree totally with Wendell. The search function used to work and I became dependent on it in managing my call backs and tracking various problems. Now I have to go through each patient individually...a real PITA. To me, this is the MOST critical thing that needs addressing.


Leslie

Damn, I hate it when you agree with Wendell over me!

Oh, Bert! I am so sorry! You are still my hero.

Leslie

Bert,

That's just a well written post. Exactly what most of us feel.

Just compare the software to your practice. Major things that would inhibit/hinder patient care need be approached first.

Thanks Travis. I appreciate that.

@Leslie, Well now I feel better. Geesh.

Wendell just lurks and then just kind of swoops in - Bert your post was very thorough and brought up the important points, but Wendell was just able to summarize his point about the search and letter writer. No matter what we all say I think every practice can use the search function and not everyone has a need for the letter writer. I use the letter writer for hospital admits, nursing home admits, letters to the pt., as well as some med lists for patients. I admit I would love more advanced formatting and ability to add my personal logo, as well as some other features, but I certainly think it is easier than doing dictation for a transcriptionist to type.

Anyway - Wendell I think was accurate in importance, but Bert who else would actually take the time to research it, come up with a workaround and then type it......we won't replace you we promise.

Oh, I am just kidding and having fun. I agree with the search function being huge.

But, just to be clear, I don't hate the letter writer half as much for what I can't do with it, but how it saves. Saving to HTML is...well...it just isn't very smart.

I think unfortunately the reason it saves to HTML is the reason we hate it.....it is hard to edit/change once done. I think that is important to AC even though doctors think it is dumb.

I would have to disagree with that one. I have written well over 1500 letters in Word and all are saved on my computer. They can all bed edited, but I am not concerned about HIPAA. If Jon were really trying to keep us from editing it and having a paper trail, one wouldn't be able to simply go in to the folders and delete them.

Plus, if that were the case, why wouldn't Jon have come on here years ago and just said that. I think it is just easy code-wise to save in HTML. Even while saving in Word or PDF would be better, it would be more than a one-step process.

I did not mean to deminish Bert's authority. HE IS THE MAN.

I too, feel that the letter writer needs work and would be better having a word processor engine behind it. I am glad Bert found a usable workaround and will use that periodically.

It's because I am so continuously frustrated by the search engine that I swooped in.

Oh, and I like lurking around here it's just the people you meet.

I wasn't picking on you Wendell - you are kind of like the silent ninja who leaps in and out........just picking on you.

For specialists, I just don't use the search function....ever. Should I be? Maybe I'm missing a big advantage of an EMR. I can't think of what I need to search except the patient's name and when their next appointment is. I could create something that I would need it for but on a day-to-day basis, it's a feature I don't use.

So I guess that's a huge priority for primary docs but not so much for me.

I guess the most important might be to recall for colonoscopies, etc. and also to look up meds that may have been recalled and you might have prescribed. When I saw Version 5 demo it has a health maintenance module that lets you choose colorectal cancer screening and then it sets date for next time. If you have someone you are following with CEA or CA-125 you might set reminders or search their charts to check something.

Wendell, did you ever get that crazy workaround to work? Ed is supposed to come over tonight. He would probably figure it out. If only he had the code for thirty seconds. Wouldn't do any good anyway. "He won't work on anyone else's code." Progammers! Strange folk. Not like us doctors.

I had five experts at experts exchange helping me until I put some screen shots of what I was trying to do. They went running faster than a patient from one of Steven's colonoscopies.

Well, we did get it to work again. At least it finds the path and opens in Word. But, as Osler points out, you have to do a few steps from there to get it formattable. I really wish it would open but without the underlying HTML tables.

Can you write a macro to seek and destroy the HTML table (text search and delete) prior to opening in word?

I was thinking from what little I know of HTML, everything is set off by tags, which you could use to eliminate them.

Maybe someone could. I've done my part, although I should edit a few of my instructions.

No, but then, I didn't get a chance. Had to put out a few fires, like my wife's computer at home crashing and me accidentally wiping the hard drive. Gave me an excuse to upgrade to Windows 7 but it wasn't pretty.

I guess that's true. I just set it under reminders for that stuff. I do it for my patients who need mammograms and colonoscopies or 3month f/u CT scans etc.

I don't prescribe long term medications so that's not an issue. I can see how that could be for the PCPs though.

I also use reminders for both of the above.
Use them often - they work great for that and Health Maint won't be able to take into account recalls for abnormal mammograms, fu after surgery, etc.

I find the reminders to take too long to get done easily, plus not that easy to work with! Maybe I just haven't spent enough time playing with reminders since I used them all the time with my old system and liked them,
Jack

If I understand what you are saying, I agree completely.