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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Disappearing HUB Button
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our SP2.5.2 (10e capable) gotcha list
We upgraded successfully from SP1C20.8 to SP2.5.2 and went live on a busy Monday in production after no testing at all.
Bottom line: it went very well, with only minor gotchas. Kept me busy last week, but a distant memory now.
Here is my list of what hit us, and we noticed:
- The doctors and scribes LOVED the new PN caret feature that allows them to pull old note fragments into the current PN. For repeat procedures specific to a patient, it is better than a template that is more generic for all patients. I did not notice that in the release notes, if it was there.
- We lost our counts of No Show, Canc, etc on the encounters list. Known bug to be fixed in later release.
- Running letters directly from Registry got broken. Needed an item key fix to switch to the Document Viewer mode.
- Medication Reconciliation is now more “in your face”. Not sure what any of that really means yet, for MIPs or whatever.
- Added a Responsible Party relationship (but mis-labeled as Insured Relationship, which was a little confusing). Nice feature, but also another annoying required field in Demographics.
- PCP/Referring Provider list got broken. Had to fix an item key to change from Drop Down to multi-select.
- eMessage templates got scrambled (into well formed HTML elements). We had to fix those manually. Tip: save as a file, and open in a browser to remove the tags.
- Messenger advanced SMS Schedule settings got overwritten to 1 day prior, from 2 days prior on weekdays only. Fixed manually.
- 10e is “advertised” in a popup to every user - there is a Do Not Show Again checkbox. I didn’t like that eCW included that, but it was mostly non-eventful.
- Hit a few permissions issues, but don’t recall which. Just a few.
- Payment Plan has promise, but I have learned to manage my expectations for the 1.0 release.
Overall, not bad at all. But odds are we’ll see a few more things in the next week or two.
Our most technical end user initially opened up 10e and was really concerned for others about how different it feels. Reminded her to stick with .exe and she was happy again. But it does work, and everything seems to be there. Just don’t see the benefit of the change yet for our environment.
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Virtual Visits
I thought I recalled that eClinicalWorks was going to incorporate technology to have real time virtual visits with patients via video such as secure Skype or something similar. Is anyone aware of where we are with that technology? We are going to be participating, hopefully, in CPC plus and are wanting to develop more non-face-to-face visit capabilities.
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Using Scribe
We have our first doctor that is using a scribe. According to scribe guidelines we need to have something in the progress note that states “ I have reviewed and agree with the above documentation as written by my scribe, blah blah blah “. eCW states they are unable to add this to the doctors signature when locking the note. Does anyone find a best practice where to document this?
thanks!!!
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Faxing The Record
Has anyone found a good way to fax office notes and documents together? For example when I do an authorization I don’t want to enter a referral to send both together but haven’t found another good way to do this.
Anyone want to share their workflow?
Thanks!
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Therapeutic Injections
Hi All, we are looking to move our injections from Treatment > Procedures to the Therapeutic Injections section (this section didn’t exist when we went Live). Right now, we have specific dosages built for injections. Example: Rocephin 250mg, Rocephin 500mg, Rocephin 750mg, etc then the provider or staff is responsible for manually changing the units. We also have a billing rule written to bounce injections out to the billers to verify in case the changing of the units is forgotten. Now that we are moving the injections to the Therapeutic Injections, I know that I could actually write a rule for each injection to change the billing units but am wondering if this is how others build their Therapeutic Injection section.
Do you just have one instance of Rocephin and then when the provider enters the order, they manually populate the dosage field so the clinical staff know which dose to administer and then have someone change the units manually?
Or do you have the injection built with all the different possible dosages and write a rule for each different dose?
Also, do you attached the admin fee to the injection when you build it? We have rheumatology that do not use the 96372 admin code, they do joint injections so when they administer Kenalog, they use an entirely different CPT code based on the size of the joint: 20600, 20605, 20610. So if I add the 96372 automatically to the injection, it is going to trip them up. OR I would have to build specific instances of the injection for Rheumatology like Kenalog 40MG Large Joint and when they administer it, it would the admin code of 20610.
I thought about maybe creating templates for some of this stuff, however, we also do provider based billing for Medicare and have a ton of CPT Explosion codes built and unfortunately, templates and CPT explosion code rules do not jive together.
I would be interested to see how others have built this. I want to make sure I have considered all options before building since it’s going to be quite the project.
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What do you find the most nonsensical/frustrating quirk of eCW?
There are many that drive me nuts, mostly UI issues:
- Tab key not following conventions and moving the cursor to the next column in areas where it definitely should, like Surgical History or Hospitalizations when you enter a date and want to enter what the procedure was.
- Text size changing when you click on a field to enter text, so you can never actually place the cursor where you want it. This should be an easy fix.
- No standard hotkey to move to the next popup in the Progress Note. Instead you have to memorize a code of Alt-M, Alt-P, Alt-U, Alt-F, Alt-S, Alt-V, Alt-A, etc., which I’ve never even attempted to do. The button should read “Next - Prior Medical History” or “Next - Medication Reconciliation” with Alt-N being the shortcut to go forward, and the same being done with “Previous” and the back button.
But by far, the one that tries my patience the most:
- The back button on the Vitals popup takes you to Medication Reconciliation, even though the previous popup was Social history. Every time I am working through a note and want to go back to review a previous section, only to have it skip me all the way back to Medication Reconciliation, a part of me dies inside.
Maybe the UI is better on the HTML5 based version?
I don’t know that venting will change anything, because I imagine these UI changes would have happened years ago if that were the case. But it may be a little therapeutic to know I’m not alone.
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Up to Date in the EMR
Are other people able to add in the providers Up To Date credentials in the setup and allow them to get credit without having to sign in every-time? Currently even those providers with the setup filled out still get a generic login when they search in UTD. They then have to click log in and type in credentials each time they search.
Just us or anyone gotten this working?
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Patient Portal Messages assigned to CCM Care Coordinator
From what I can tell, portal messages can only be addressed to providers per the drop down list when logged in to the patient portal. Is there anyway to add our Care Coordinator’s name to that drop down list so that our CCM patients can send her directly a message instead of having to choose their provider and then it be routed to our staff member who must then route it to the Care Coordinator?
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preferred name fields?
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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Referral Notes
How does everyone track the internal back and forth on referrals? We use the notes field with timestamp to track everything but that’s sent on referral. Currently our stuff “cuts” the notes, sends the referrals, and “pastes” the notes back in. This makes me uncomfortable for many reasons so i’m seeking a better solution.
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Add New Rx favorites
I would prefer to enter a single drug name into My Favorites in the Add New Rx section, and would like to add different doses and directions which would be visible once the drug name was clicked on. Instead, when a drug is accessed now, there are multiple entries of the drug that I have saved prior, and I must click on each to find the formulation and dose, etc., that I wish. So, is there a way to enter the different preparations under a single name?
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Two finger scrolling not working anymore in unlocked progress note view
I replied to an old thread, but realized it is a slightly different problem. I have a Windows 10 laptop (Lenovo T550). I use the touchpad, and do not use a mouse. Initially, two finger scrolling worked great, until all of a sudden it stopped working. Now I have to use the scroll bar on the side. I uninstalled eCW and reinstalled it, but the problem persists. Two finger scrolling works fine elsewhere, for example, when editing the HPI which brings up a separate pop up window. It seems like a minor problem, but this is a big problem for me in terms of efficiency and ease of use. I did recently update the touchpad driver (Synaptics), but the two finger scroll continued to work fine initially after the update. I tried rolling back the driver to the original version prior to updating it, but that did not fix it. I have tried several restarts. Please address this issue. Any help would be greatly appreciated.
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If your macros are not working read this
I was having problems with the macros not populating the free text box when used
the instructions say to hit ctrl space bar and then type in macro short cut
the instructions in the v9 feature highlights appear to incorret
type in the macro shortcut then hit ctrl+space bar and they work.
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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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Statement on progress note indicating that sections have been reviewed
Hi All,
According to our coders, there needs to be notations in the progress note indicating that the provider has reviewed the information. For example, Social History, ROS if the clinical staff entered it, etc.
Does anyone use this workflow? At the moment, we do not. I think the fact that the provider actually locks the note, it is assumed the information was reviewed, however, that doesn’t seem to be the case. Does anyone have canned statements built into sections of the note that the provider can timestamp and bring into the note? I know that there is a co-sign feature for mid-level to provider, however, this really doesn’t fall into the same category. This is just stating that the provider has reviewed the information in the note that the clinical staff entered. And also, we have recently hired a scribe so they want the provider to be able to indicate that the information was reviewed.
Thanks!
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Manually enter labs in yellow grid
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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Need Info Regarding APU Tool
What ports need to be opened on the servers for the APU tool to work? Can’t seem to get an answer from eCW.
We have multiple servers hosted on site. Has anyone recently upgraded and did not have to use the APU tool because eCW upgraded for you? If they did the upgrade for your, what was the reason?
Thanks.
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eRx Change Prescribing Provider
We currently use generic resource schedules linked to our medical director. Our NPs do not maintain their own schedules. Currently, when they prescribe all the prescriptions are sent out with our medical director’s name. Is there a way to change the prescribing provider without changing the appointment provider?
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Meaningful Use Patch/SNOMED
Was anyone else SURPRISED Monday morning when the SNOMED code mapping and Meaningful Use pop-ups started appearing? Apparently there was a patch that occurred for cloud hosted users. We never received any information/education in regards to this patch. Monday morning was a little interesting to say the least. We had 83 providers and over 300 staff confused and upset that they weren’t notified.
I created a ticket with eCW and was emailed a “release document” dated January 2017. We searched in support emails and on the customer care portal could not locate this document anywhere. After many discussions with our SAM we were informed that yes this was a patch, and yes they (eCW) agree they should have notified the end users.
We are supposed to be receiving further information and education “sometime before noon today”. Hopefully then we can correctly educate our users. Our guess is they pushed this patch out in order to be able to release the MAQ dashboards by the end of April.
Does anyone have any additional information they can share or possibly how this “patch” works and what it means for the offices?
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