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Delimiters, in, the, notes, in, Therapeutic, Interventions

October 13, 2005, 9:58 am
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I am building a template for a pre-op total knee talk, I need a good place to build a long paragraph discussing the risks, There is a section under “therapeutic interventions” called “discussion” and I thought that would be a good place, But the window is too narrow to type alot of text into, plus I can’t tell when the character limit is going to hit me—so I decided to put in one sentence at a time in the pick list and then pop in each sentence, thus building a paragraph in the template.,

Are you following me?,

But the program puts a COMMA after every sentence and—unlike many other windows—THERE IS NO APPARENT WAY TO CHANGE THE DELIMITER,,,,,,,,

Can someone tell me how to control the delimiter in this section?,,,,,,,,,,,
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

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eClinicalTouch2 update and eClinicalTouch3

April 13, 2017, 7:57 am
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If you are on SP2, do not upgrade “eClinicaltouch2” to version 2.23, stay on 2.22.6.  If you upgrade to 2.23 it will no longer work with SP2 and you will be prompted to use “eClinicaltouch3”.

Good news is “eClinicaltouch3” is now available from the iTunes store.  We are on SP2, and keeping our eClinicalTouch2 at 2.22.6 and downloading eClinicaltouch3 so that we can use eClinicalTouch2 in production and give us some time to evaluate eClinicalTouch3 before we deploy to all of our users.

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Cancelling Cloud-based eCW

April 13, 2017, 8:44 am
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I closed my solo practice in August 2016 to take an opportunity at the University.  My EHR with eCW is cloud-based and was instituted in May 2012.  I’m trying to make a decision about how to migrate my data.  Has anyone ever done this?  eCW gives me essentially 3 options.  #2 is ruled out for me as I cannot migrate to my new EMR.


1.  HTML Hard Drive:  We will provide you with your data in HTML format.  Included in this data option will be the following:  EMR (Progress Notes) and PM (CSV Format.  No claims data.  This will include Pt Demographics, Insurances, and Appointments.)  and FTP. An additional charge, will be charged for an encrypted hard drive on which we will provide the data. Cost $5000

2.  Data Export:  Should you require for us to export your data to another EMR we will have members of our Data Migration and Post Implementation teams provide you with options and pricing associated.

3.  Hard Drive/Relational Database Format:  We will provide you with your data within SQL.BAK format. We will provide you with an encrypted hard drive.  There is a cost associated for hard drive . You will require the conversion of the data to another EMR.  Cost $2500


eCW also offer an option of keeping the website “static” for a contract of one year.  Cost $1200. 

I think option #1 is probably best and have queried eCW about how it’s searchable.  eCW has not been able to give me an example of what the files look like.  Currently I’m using the system every day to print out old notes and pathology reports (etc) for old patients who are seeing me at the new place.  My concern is that the hard drive will be hard to search for individual patients and documents to print out. 

Also I assume if I went with the static option for some period of transition time the Registry function will not be functional.  I am using that often as well although the ability to continue using the Registry function is a less important in my decision making.

I also think $5000 seems pretty expensive for option #1.  Is there a way to download the data on my own?


Thank you very much for any advice.

Lora Hebert, MD

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Going to cloud, tips when read only x 2-3 days

March 27, 2017, 9:51 am
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So we are taking the plunge this week migrating to the cloud….

When we are in the read only mode as the hard drive ships off (for us it is thurs, fri and sat)  we will be documenting with paper notes. 

We were wondering about tips for:

1) credit card usage.  Do you run cc’s through transfirst website since it cant be done via ecw?  Or otherwise how do you handle incoming $$$.

2)  moving patients through the building.  Can you change the status on the ‘S’ bean when someone checks in?  I assume that is frozen in read only mode as well?  We might see 200 patients that day and were trying to figure out how to communicate to the back 2 wings that there is a patient ready to be brought back. 

3)  scheduling.  I assume we will use excel sheet in a cloud with several schedulers having write access add patients to the schedule for appts the next couple days.  However I assume if a kid needs an appt in 3 mo we would ask them to call us back to schedule?  Or is there a better way?


Thanks!
Chris

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Kiosk payment issues

April 14, 2017, 5:50 pm
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We are using the kiosk and have been wondering if there is a way to change the settings so that the patient can choose the amount they would like to pay that day rather than only having the options to pay the balance in full

Also, when they do choose the pay the balance, it is only charging them the balance minus $1 which we then have to work to collect

Any advice?

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Inaccurate scanned document log

April 17, 2017, 8:37 am
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Our front office staff perform most of the scanning in the practices. Recently, we’ve noticed that the logs do not appear to be correct.
Several different ways of scanning and none of them produce an accurate ‘scanned by’ log.
ECW support states it is a glitch and will be fixed in a future version.
Having just upgraded to SP2.5, concerns me.
Its not happening to all users, just some.
Has anyone else noticed this and, if so, was there a more productive/proactive response instead of the ‘next version’ fix?

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Compound Medications Best Practices

April 17, 2017, 10:59 am
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Hi all

I was curious if other users could share their tips and tricks on how to best managing compound medications in eCW.

Is anyone aware of eCW Materials / Instructions for managing these?

How do these work with the new NDC check?

Thank you in advance for your help
Tyler

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preferred name fields?

January 23, 2017, 1:49 pm
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I was hoping now that there are quite a few practices using the new SP2/10e versions if anyone can confirm that there is a place for “preferred” name throughout eCW?  Specifically if it is visible on the Office Visit screen?

We have quite a few trans-gendered patients who go by a different name than their legal name.  We were told that in the new version the preferred name would be visible and standardized across all screens.  It is so embarrassing for both our nurses and for our patients when they are sitting in the waiting room, and they get called back as “John Smith” when they look like and also identify as “Debra Smith”.  Our nursing staff use the office visit screen to call patients back and at this time there is no way of them knowing what name to call the patient without looking at the screen.

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Disappearing HUB Button

April 18, 2017, 9:10 am
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See screenshot. We haven’t been able to pin-point what circumstances/clicks lead up to the issue, but intermittently the HUB button will disappear from the appointment screen. Simultaneously, the co-pay/insurance eligibility panel disappears. It seems, more often than not, an error ‘Could Not Load the Requested Page, try again!’ pops up. Users are forced to log out and back in. We’ve checked the display settings and have tried Windows 7 Basic theme. Help please!

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Substance Use/Substance Abuse Speciality

April 18, 2017, 6:43 pm
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We are starting to do the prep work to add substance use onto the EHR/CCMR. When we signed onto eCW, we were told there were security settings in place to ensure we meet our legal obligation (42 CFR). I am in conversations with eCW as there does not seem to be a solution other than a separate eCW for them. Do any of you have substance use or behavioral health on your EHR with other specialties?

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CHADIS   - any news?

April 19, 2017, 6:49 pm
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We heard in 10/2015 about the CHADIS interface at the NUC.  It was discussed again at the 2016 NUC.  Reportedly it was coming Q1 2017.  It is on the CHADIS website like it is already ready but it is currently in beta.


Any news when this might be available?  If ECW is needing any further beta testers, our practice is willing to help get this up and running.  It will be SUPER useful once it is live.

Chris

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Surprised by lack of CCM users on forum

April 20, 2017, 7:21 pm
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Jan 1, Medicare approved billing for Chronic Care Management.  One the requirements is a care plan.  I’m surprised that hardly a single person has remarked on how to use (or more importantly how poorly developed ) this module is.  You must have a Care plan to show medicareincase of audit.  Isn’t anyone having trouble using this module or is it just me?  If it is jsut me, please help me.

How many questions and section must be answered on each problem in the care plan?  ECW tells me ALL which is nonsense.

How do you handle chronic conditions that ECW has not created themseleves.  I created my own problem like Chroinc urinary incontinence but ECW states that does not count and work in the care plan.  Why the hell not? 

How do I delete a problem from the careplan once added by mistake?

How do I create/use the CCM module problem template?

Can I manually shorten the Default questionnaire for Hypertension??  If so, how do I do it and how do i save it to use a s a CCM problem careplan?

I’m doubtful anyone has answers but I’m skeptic anyone is using ECW to do the careplan portion.  Users here are too smart to just follow ECW laborious steps

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Diagrams for Physical Exam

January 12, 2016, 2:36 am
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I love ECW, but I am really missing a function which was present in my previous EMR. I am referring to body diagrams which you can make drawings on and include the picture as part of the physical exam. This is very important in surgery patients because you get a very clear picture of where the abnormality is.

“A picture is worth a thousand words”

Examples:
1.  A breast diagram which clearly shows where the mass is, what part of the breast and which side. Also you can show scars from previous surgery and make notes such as the character of the mass.

2. An abdominal diagram will note the position of the abnormality ... especially useful with hernias, abdominal masses.

I have spoken with IT about this and we have tried to figure out how to add diagrams to the physical exam section, but results have been futile so far. We tried capturing non-native diagrams with Snagit, etc.

I seems the program was designed mostly for non-surgical practitioners.

Any suggestions?
Thanks.

John Clarke

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Dragon Medical One causing Freezeup of Screen

April 5, 2017, 12:17 pm
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For the last few months I have intermittent freezeups of eCW at random times. My IT guy and multiple support calls did not find any solution. ECW will freeze up completely and you cannot even x out, you have to use task manager to quit the program. It is only happening on the 2 computers that have Dragon Medical One on it (which is the online version, recently installed) so I think this may be the issue. Anybody having the same issue?

Thanks for the input.

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V-10 SP2.5.2 10e

April 21, 2017, 7:47 pm
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Hello,

We are currently in the process of adding the fax portion of eCW within our system. One of our staff members discovered that the progress note information can be altered by staff before it is sent via fax. It’s my understanding that in order to resolve this issue, we will need to upgrade to V-10 SP2.5.2 which is based on 10e and the release notes are also based on the 10e.
We are not ready to give staff the ability to log in using the web browser as of yet for 10e.

To the users that have had this upgrade: are there any other changes for staff within this upgrade other than the 10e? We are really just looking for the bug fixes within this upgrade.

Also, our 3 servers are managed off site, can anyone advise of any major issues that they have encountered with the upgrade?

I appreciate all of your help.  Image may be NSFW.
Clik here to view. grin

Thank you,

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Best free TIFF viewer?

April 24, 2017, 8:25 pm
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Greetings, I’ve never liked the Windows Pictures and Fax viewer to look at eCW documents.

I’ve used Free Brava Reader for years but now you have to uninstall it and re-download it every 3 months.

Does anyone have a good free TIFF viewer that they would suggest?

Thanks,

Jeff

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CCDA Validation Result issues

April 26, 2017, 12:22 pm
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Is anyone having issues with this CCDA Validation Result? We keep getting errors: allergies not documented and current medications not documented.

Here is the scenario. Patient had a new patient visit last week. We do a complete note with allergies and meds verified. The next day the patient comes back for a biopsy. We have the biopsy visit type set up as an operative report. The operative report does not have a current meds and allergies section. So say after the biopsy, we want to send out a referral to a specialist or maybe send the consult note from the first visit back to the PCP, this new validation process is looking at the biopsy note because it is the most current visit for the validation.

We are running into the same thing with say sending a referral from a telephone encounter when the last visit was a nurse visit for a lab draw. We don’t verify the meds or allergies again at the nurse visit for the lab draw as the patient was just in and is simply coming back maybe the next day for a fasting lab draw. If we want to send a referral from the telephone encounter, it is looking at the nurse visit and gives the error about allergies and current medications not being validated.

Is there a way to exclude certain visit types so the validation does not look at those types of notes? I’m not finding anything about it in the documentation so I’m thinking no. We want to make sure we are meeting the measures but these are scenarios that we will run into quite frequently. Of course, we can have the nurses start validating meds and allergies for the nurse visits but we don’t have a way around the operative report issue.

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Psychiatric charting

December 6, 2016, 11:16 am
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I have a psychiatry specialty starting soon in my affiliated group practice.
Does anyone have this?
How do they secure the records? Make the entire note confidential? Can I make parts only confidential?

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Current Medications - V10e, JDK 1.8, and Tomcat8

April 26, 2017, 2:33 pm
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As of last week, our current medications dialog box on our desktop 10e started failing for us. We can no longer set Taking / Not Taking etc.  The web app 10e current medications still work. Is anyone else facing this problem?

An eCW tech states its due to our JDK 1.8 and Tomcat8 software. They recommend we downgrade to JDK 1.6 and Tomcat6. However, we had this version since we started using eCW and we never had this current meds issue until recently.

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Manually enter labs in yellow grid

April 28, 2017, 10:20 am
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Is there anyone out there that manually has your office enter lab result data into the yellow grids? If you do, how well is that working for you?

We have an interface for labs done in our hospital but have chosen not to manually enter any results from rival lab companies. Our providers just reference the documents section for those.

Thanks,

Dave

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