Our MAs have brought it to my attention, when entering vitals, they can tab through until they reach HR, then they must tab twice to get to the next RR, then when they tab it jumps back to HR, then they can tab through to O2Sat, tabbing jumps back to HR again! Has anyone experienced this issue? I have opened a case, but so far, I have shown about three people what is happening but no one has a resolution yet. Thank you in advance 
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Vitals not tabbing consistently across grid
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v10 role based security spreadsheet?
Hi all,
Is anyone willing to share a current role based security spreadsheet for a family practice clinic? Thanks in advance 
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CDSS - Can we update a previously satisfied measure?
Good morning!
Is it possible to update a previously satisfied measure in CDSS?
ie: Patient had a colonoscopy in 2010, which satisfies it until 2020.
However, patient was symptomatic, and had a colnoscopy this month.
We need to update that (green) satisfied measure, so that it is now satisfied until 2026.
Any ideas on this? We can’t seem to figure out how to update anything once it is green (satisfied)
Thank you 
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NEW MANDATORY DOWNGRADE????? (RANT WARNING!!!)
We have been forced into a feature called“CONCURRENT LOCK” (part of the new “MANDATORY UPGRADE”)
This means that now “ONLY ONE PERSON CAN USE THE CHART AT A TIME”.
This lock defaults to 15 minutes between users. That means each person who touches a patient chart must wait 15 minutes after the last user of that patient chart is finished with it.
We have been quite charming the past 2 days yelling up and down the halls
“Hey, are you out of there yet, so I can do my work?”
Our SAM has gotten us a concession with the programming gods to only make us wait 2 minutes between users.
Now we have at least 8 minutes added on to the time it takes to see a patient.
If you aren’t lucky to have a good SAM, you may have an extra HOUR added to the care of each patient.
INCREASED TIME TO SEE A PATIENT WITH CONCURRENT LOCK OF ONLY 2 MINUTES
+2 MINUTES CHECKIN
+ 2 MINUTES MA
+ 2 MINUTES DOCTOR
+ 2 MINUTES CHECKOUT
8 EXTRA MINUTES PER PATIENT!!
GOOD GOING!! GREAT PATIENT SAFETY AND EFFICIENCY MEASURE!!
A really “special feature” is the NASTYGRAM that is flashed saying so and so is already in the chart. Then, at times, the program just crashes after the NASTYGRAM. We work on screens that are visible to the patient. When all this occurs, it is very embarrassing.
It is ironic, that one of the biggest selling features in moving from AMAZING CHARTS to ECW for us was that more than one
person could be in the chart at the same time.
There are some instabilities to ECW that have been there long before we ever started experiencing loss of HPI or treatment data. We have for a LONG LONG TIME, only used one section at a time because of this instability.
Just admit that this is not an increased “patient safety” feature, it is a way of decreasing the program’s instability (not losing data the way it has for years)
What about this from your the information page:
Recommended User Action
£ Contact eClinicalWorks Support to enable the Item Key called EnableConcurLock if your practice does not allow connectivity to APU. This Item Key prevents simultaneous access to the blue links on the Progress Note (Chief Complaint, HPI, PMH, ROS, Vitals, Exam, Assessment, Treatment, and Billing).
Action Taken by eClinicalWorks
þ eClinicalWorks has an Item Key called Item Key (EnableConcurLock) that provides a series of pop-up access warnings to users who are attempting to access a portion of a chart that is being used by another system user. The user can then make an informed decision on whether to continue to access that area of the chart.
þ eClinicalWorks has enabled the Item Key (EnableConcurLock) for all eCW Cloud customers.
þ eClinicalWorks has enabled this update to all APU-connected client/server practices.
Note: The Auto-Practice Upgrade tool (APU) will be enabled by default. If you choose to not have this capability enabled, contact eCW Support to disable this feature.
If Admin wants to move this to the Watercooler, feel free. This is such a significant step backwards in the name of an upgrade, I thought it should at least start out here.
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User Log Report
Anybody else get hit with this yet? (M jellybean message everyday for every user showing when and where they logged in the prior day)
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FYI - SureScripts is down
Appears they went down at 2:35PM EST. ECW is aware and working with them on a resolution.
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Paper in the exam room
Do you use paper in the examroom? If so, what for? If you got away from it, how did you do it? What was the work around and substitute for paper?
We are making a push to get a way from paper superbills. We have conviced the physicians that they should be entering their ICD and CPT codes and ordering their own labs but we continues to get push back because the physicians use this to make notes also, such as requesting records.
Any help or suggestions will be helpful
Thank you
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Inventory
I didn’t see a better place to post this so forgive me if out of place. Does eCW allow or have any type of inventory feature/function? We are trying to find something of this nature…thanks for any input.
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telephone encounters - order of messages
I noticed that the telephone encounters are always ordered according to the date that the message was created. This is a problem for me, because I may have 10-15 messages in my inbox, and if I assign an older message to my assistants, and get a reply back, the message shows up in order according to the original encounter creation date, which may be near the bottom of the list, rather than showing up at the top. In other words, it is not always evident that there is a new reply or message that requires action to be taken. It would be best if the messages were ordered according to the most recent response, rather than the date of original creation.
I just made a patient mad for not calling her back because I did not realize there was a new response to a telephone encounter at the bottom of my encounters list.
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10e User Reviews
If you’re a practice using/piloting 10e, please post your impressions here for the community to see.
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Locking Progress Notes
Is there anyone who’s providers are not Locking the Progress Notes, but actually someone else locks them for them?
Our providers mark the Progress Note DONE, the coders then review the notes for correctness and notify the Providers to lock them if everything is ok. Well they don’t lock on a timely manner….....
Administration has requested that the Coders be able to lock them.
I was wondering if anyone else is doing anything similar?
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Upgrade to 10.0.8
Our clinic just upgraded to 10.0.80 SP1C-5 this weekend. My first frustration is that there is no information or documentation on what is included in the upgrade. It was our understanding that it was going to be regarding ICD10 and eprescribing. A second frustration is the new info included on the visit summary. Patients have a hard enough time sorting out the medications section but now you are going to add preferred language, race and ethnicity. I’m pretty sure they know that! Smoking status is now a section that cannot be removed. Pt’s know the answer to this as well. Frustration comes because eCW can obviously manipulate the info that is printed, why not make it logical information that would benefit the patient?
If there is documentation that I missed somewhere or if there is a way to change the settings on the visit summary, then please let me know!
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SP1C-20.3 upgrade impressions/issues
Ten days ago we upgraded to SP1C-20.3. The aftermath?
Speed is the same (we are locally-hosted).
The ICD-9/ICD-10 icons are a nice feature.
Users will have to upgrade their workstations at the first login after the upgrade. Ours all took 45-90 seconds, even at remote locations with poor Internet more than 500 miles away.
Problems?
1) Document previews (Reports button for faxed/scanned results, for example) were unreadable. After several days, it seems to have been resolved.
2) When writing new prescriptions, the popup below appears. eCW says once you set the NDC, it should stick, but it doesn’t. You need to do it every time. Our providers have adapted by blowing past it and not setting the NDC and things appear to still be going fine electronically. It is, however, concerning.
3) Outgoing faxes broke. Has since been fixed.
4) We had a template loaded for our Claims Summary with our logo and provider/tax ID, which broke, just like it did when we went to C7 last summer. Since resolved.
5) The new Security feature enabling the ability to restrict users’ ability to delete meds in the Med Rec window come with all users disabled. You will have to select those users with permission.
6) You will need .Net 4.5 installed on each workstation. We update .Net routinely through Windows Update so it wasn’t an issue for us.
7) The default for the Med Summary in the right chart panel is set at “Medication.” Your users will need to go into their My Settings and change it back if they used “Date.”
8) The Sel button has been removed from the Progress Note.
9) You cannot add a new item/property to a medication from the popup when prescribing. The hyperlink does not save the change, nor can you edit it the Strength or Formulation by making it a Favorite.
All things considered, it could have been worse, but also it could have been better.
The Document preview issue was a little frustrating. If you have the issue, don’t let the Engineer tell you all settings are fine but nothing can be done. You’ll have to push a little because they finally did change something to make it work.
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CDSS - Can we update a previously satisfied measure?
Good morning!
Is it possible to update a previously satisfied measure in CDSS?
ie: Patient had a colonoscopy in 2010, which satisfies it until 2020.
However, patient was symptomatic, and had a colnoscopy this month.
We need to update that (green) satisfied measure, so that it is now satisfied until 2026.
Any ideas on this? We can’t seem to figure out how to update anything once it is green (satisfied)
Thank you
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Alabama Immunization Registry Interface. Need help!
So this post is really to see if anyone at eCW can help us out on this matter:
We have been trying to get eCW to establish an interface with the Alabama state immunization registry (known as ImmPrint) at least since 2011. I have emails dating back to 2012 with eCW on this matter and honestly for the last 4 years all I get is “It’s being worked on. It will come.” ImmPrint has said they have been ready with their side of the interface for several years now and just waiting on eCW. A lot of other EHRs have already interfaced with the registry. We can’t understand why eCW is taking so long except for that we are being ignored. My last email from eCW stated: “We have completed the connectivity with the State of Alabama this month. Now we are setting up the HL7 for Immunizations messages as well as Testing. This will take some time more for us to proceed and Install the practice Interface.” When pressed for what “more” time means, I got a response of “months” which honestly is the time frame I get every year. Our state registry implemented a new policy in April 2016 that all of the certificates of immunization (COI) that we give to patients to give to schools/daycares must be printed from their website. Thus, we have to manually enter in all of the shots we’re giving into the ImmPrint website.
We’ve been an eClinicalWorks user since 2008 and have done numerous demos to practices to show how much we like the system over the years. However, this lack of an interface has now made our EHR not recommendable.
I hope that Girish or anyone at eCW still monitors this forum and see if this can be escalated. Thanks!
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CPT explosion codes for Laboratory
Where is the best place to build explosion CPT codes in eCW?
As an example: H. pylori antibodies IgA, IgM, and IgG are coded as 86677 x 3
If I add under the Lab area and associate CPTs, I get an error that this code is a duplicate.
Thanks
Mary
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Healow App only allows messaging to Top 50 Providers
For you with larger Facilities. We have over 100 Providers. When trying to send a message from Healow, all of our Providers do not show in the list. It only shows the first 50. When speaking with eCW, they told me that was the max. Is this how it is with everyone else?
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What happens when you delete a HPI subcategory?
We use a couple HPI subcategories as questionnaires for our dental visits. One has questions about the patient’s PCP, last dental visit, etc. Others have questions on diet and oral hygiene to assess a caries-risk score. These are filled out at a patient’s initial visit, then on future visits they copied into the current progress note through the yellow carrot.
One of these questionnaires called “CRA 0-5” is listed as a “Symptom” under the category “Dental” (see second photo below). Then when you click on that symptom, you see all the questions and can enter the responses. However, we’ve realized that it would be better to change “CRA 0-5” to be a subcategory like “CRA 13-17 SLC” and the others (see first photo). Then we would have each question be a symptom that can be checked as c/o or denies.
So here is my question. If I go in under the admin settings and delete “CRA 0-5” as a symptom under the category “Dental” so that we can add it as a subcategory like the others, what happens? I assume nothing happens to the previously locked notes, and they will still display the “CRA 0-5” questionnaire as we filled it out before we locked it. But on future progress notes when we click on the yellow carrot on a new progress note, will there be an option to copy the previous “CRA 0-5” questionnaire to the current progress note? I assume not, because there would be no current “CRA 0-5” symptom to copy the answer to, right?
Thanks!
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Heath Trackers Portal integration
Has anyone started using health tracking devices through the Portal? We were told recently that this feature was not available yet for client server practices.
I was just curious to see how useful that information has been to providers who do have access to it now.
Thanks,
Dave
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*****WARNING***CHECK THE ICD CODES IN YOUR CCM CLAIMS****
Luckily I have a wonderful SAM right now who is helping us begin to address a potential problem for all
docs having CCM claims generated in their name.
CURRENTLY ECW USES EVERY SINGLE ICD CODE FROM A PATIENT’S PROBLEM LIST AND INSERTS IT INTO THE CLAIM
I am a very very conscientious doc and live and breathe my patient care 24/7.
I have a wonderful support team. That being said, there is no way we could work on every chronic condition on every patient every month.
I AM SCARED TO DEATH RIGHT NOW.
UNINTENTIONAL FRAUD is still FRAUD.
I CAN SEE THE RAC AUDITORS SALIVATING ONCE THEY GET WIND OF THIS.
If my practice manager and biller hadn’t been sitting at a table working on charts at the same time as me and asked,
“Why are you submitting 11 diagnoses on this CCM claim?” NEITHER ONE OF US WOULD HAVE EVER KNOWN.
For now either the biller and/or myself need to do extra work each month. Either I have to create an encounter that lists ONLY THE CODES I ACTUALLY WORKED ON (from the CARE PLAN) and/or the BILLER has to go back into the patient’s care plan and whittle the codes down to the ones on the CARE PLAN.
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