For the longest time we have just been doing these past testing reviews in a Laboratory Data Category under Physical Examination.

But that doesn’t seem right.

Any suggestions?

Since we do not have an interface available with our Dept of Public Health lab, we scan in all our lab results. The staff attach each scan to the corresponding order. On occasion, the window to select the lab is blank as if there are no orders, which is not the case if you look at labs in the Pt Hub. In the past, I would have to reinstall the eCW client at the scan station. I have reported this in the eCW and they have reinstalled eCW as a fix. Any ideas?

I thought there was something wrong with me, but found study showing average provider spends 2 hours charting for every hour patient time.  I wish someone would make a usable EMR.
Every update of eclinicalworks brings more nightmares.
the 10e version is not even usable after all these years.  It’s horrible, and there is no reason for it to be so bad.
Are there any practicing physicians that actively influence how this software is designed, or is it computer programmers expecting providers to adapt to the software?

I cannot write Humalog for some patients.  the system won’t let me prescribe it. It shows up in the Multum list, but try to add it and nope, just forget it. You cannot recreate the problem?  I literally sent you a video capture of it, how about now?

I tried to write Tresiba, nope.  It has been out for a long while but still not in the database.
This is an EMR, and a basic function of an emr is to write and follow prescriptions, right?

Try to import medication from “external Rx history” into chart, which is a quality measure we need to report, nope.  It doesn’t work.  “could not find the matching drug”

Want to add a colonoscopy result, should be easy but no.  Multiple clicks, add Facility is mandatory ( WHY), Order date, performed date, result date - most important is performed date and thats not even what shows up for tracking.  THEN you have to go somewhere else to enter when it’s due again. 

Want to add educational material, sure.  Go through another ugly interface, add a few and you have multiple clicks to add it.  If you are lucky not to get the “an exception occurred when publishing patient education material to the portal”, it publishes and you get an OK button that it worked.  Yeah!, click that. now what, Do you want to document this to the assessment, well duh, yes. Another window, “Patient education, Prediabetes: Care Instruction material was published to portal” = um,stop, ok.  Why was I not done when I clicked it first clicked it?

Want to update the social history smoking and alcohol use, it works so well I get multiple copies of every entry, sometimes 10 or more that take up a whole page.  Want to fix that, nope.  You cannot, nothing you do will make those mysterious copies go away.  It’s a bug, they will fix it one day.  I’m pretty sure this equates to we’ll fix that one bug just as soon as we find 20 more to add to your problems and make your life a miserable living hell.

eCW is my most expensive employee.  I’d fire anyone else years ago if they performed this poorly, but I keep giving them a chance in the hopes somebody there will whip this company into shape.  Go all Steve Jobs and demand perfection ( I’d settle for functional at this point).  This software should simply not suck so bad.  It should just work.  As a bonus, it should help us work smarter.

These are just todays frustrations, and it was a half day.

Frustrated.

We have identified a major safety patient concern in this version of eCW (Version 10 Service Pack 2.3), outside of the concurrency lock issue that has been discussed in several different threads.  We are interested in knowing if any other practice is experiencing this and if so what resolution ECW has provided to you.  We are still waiting a fix from eCW presently on this issue (and have reported to our SAM and have current tickets open):

We have identified the following problem in this version:
•  Medical History are automatically pulling forward into encounters when the progress note is opened.  If you click on medical history or allergies or any of the other history section in the future encounter note, it then gives you an exclamation point in past open encounter notes in which it states if that section is up-dated, the information will not pull forward into future encounter notes.  The providers are then left with no way to up-date histories or allergies in the note with the exclamation point and any information added to the right chart panel will also not carry forward.  This leads to histories that are not up-dated and allergies that are not carrying forward to future visits correctly. 

•  When updating Medical History from the HUB, it does not pull forward into future progress notes.  Advised by eCW Helpdesk- and were told that HUB is view only and if you update anything it does not pull forward in to any future progress notes.  But yet there is still an ellipse button present that gives the impression that you should be able to update from the right chart panel. 

Scenario to give you an example of what is happening:
zzTest, Patient has an appt with PCP on 1/3/16 at 10:00am. Pre-visit prep staff opens the progress note 2 weeks early from the provider’s resource schedule and updates the chief complaint with “Due for Hgb A1C, urine albumin/creatinine, diabetic foot and eye exam”. Provider opens the progress note 1 day before the appt and updates the medical history with “New lung nodule”

Test, Patient comes into the clinic for an urgent care visit on 12/22/16. The provider needs to update the medical history with pertinent information for the PCP to follow up at the scheduled visit. They are unable to due to the red exclamation next to the medical history.

Patient arrives for his appt with his PCP at 10:00am, provider opens the progress note, the medical history and the right chart panel are not updated with the very important information from the urgent care visit. This is a problem!
  At this visit, the patient also sees Behavioral Health and the Care Coordinator, they each make appts on their resource schedule at the same time. They each open a separate progress note, the medical history is pulled forward but the PCP has not finished updating the Medical History yet. The medical history is not the most current in either the Behavioral Health or Care Coordinator progress note.

The medical history, all other histories and allergies will not be the most current in future encounters as it is pulling from the last progress note.

Thank you in advance for your response as we are desperate for a resolution from eCW on this one!

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. 

Thank you,

Our practice is considering going to the 10e. We would like to know if there are any other practices located near the 29505 or
28383 area that a few of us could go to their practice and take a look at it and talk with the staff about the transition to the 10e?
We are currently on V10- SP1C-20.8

Thanks

It has been two weeks since our upgrade and I wanted to give some advice/input. This is a long read but probably worth the time.

Have someone login as soon as the upgrade is complete and uncheck all boxes “Allow user to access 10e”. Also, make sure the box in file > Settings > Practice Default > General > “Show 10e URL Browser Dialog” or users will get a pop up advertising 10e. Ours was already unchecked but I recommend verifying yourself.

The upgrade itself went smooth as far as the client side upgrading on each computer. We didn’t have to manually install the MSI file on any computer. I researched the upgrade for months and thought I was prepared for what could come but boy was I wrong. There were so many issues I can’t begin to list them here but a few main ones on the EXE. version: ERA’s combined per patient, fixed with item key. Security attributes galore (progress note accessibility and many others), eMessenger stopped working completely, some printers stopped working (in eCW only), concurrency lock mess but I was prepared for it thanks to this forum, and many other things I can’t think of at the moment. I’ll post the other issues as I recall.

Like many others i’m sure, we have been excited about 10e and all the potential it brings. So far it has been a complete nightmare. If we went directly to 10e the morning after the upgrade our clinics would had to have closed the doors. The required plug-ins wouldn’t download and eCW had to send them (took 3 days) to be manually installed on every computer using 10e. Luckily only three users are trying to use 10e at the moment. We still get a “failed to update plug-in” error every time we login. The way our infrastructure is set up I will have to physically go to each computer and install these plug-ins.

Eprescription Log didn’t work - was told it was a bug. Was fixed days later

Labs received electronically are coming back and you are unable to change the Results field, it is greyed out. You can’t uncheck received then change the result. eCW said it was a bug.

Lab interface completely stopped working with 10e. Haven’t had time to troubleshoot this yet.

The batch scanning issue made an MA laugh and walk away.

Document management screen was different depending on how you opened the browser. Did you open it from Help > Launch 10e or copy paste the URL into a previously opened window of Chrome. This issue needs it’s own topic which i’ll make later. It was a disaster.

Get ready for Chrome troubleshooting, every time support would remote in it was all about clearing cache/history over and over and making sure you were using Windows Basic theme.

There are too many other things to list but overall I’m disappointed. There are some things the provider using it liked, and I can see the potential. Unfortunately it comes at a bad time and there are already mumblings here from the higher ups of using the free data switch to another EMR. I’m staying out of that conversation but I truly want eCW to work. The reality is it simply doesn’t on so many levels.

Thanks,
Tim

1. The patient search function
on the ccm list of my patients of enrollments works only intermittently.  I can try repeatedly and it wont work.  A half hour later it works and then halff hour later it doesn’t work again.
2. Report Page not updating
The report page is not reflecting the patients we have already completed enough minutes to be eligible for billing.
3.  Of course the timer still has numerous issues-sometimes it appears to turn off, but only at times when I return to the patient, the timer is still running and the log is lost.
Sure wish this feature was taken more seriously.

Anyone using either Plusoptix or the Welch Allyn Spot screener?  At least the Plusoptix says it can coordinate with “most EMR"s, but can’t give me any specifics.

I have to buy two new vision screeners—any advice would be helpful!!!

Thanks

Since the last Windows update last week (Windows Malicious Software Removal Tool for Windows 8, 8.1, 10 and Windows Server 2012, 2012 R2, 2016 x64 Edition - June 2017 (KB890830)) we cannot print multiple office notes at once.  The tech I just spoke with told me that all practices with this update are unable to print.  Is anyone else having this issue?  She said there is no estimate on resolution, just that they are “working on it.”

This is really frustrating for our Medical Record staff and the Front desk also.

We get previous medical records on CD all the time. However, we have had trouble importing them into the system, especially as with today’s bloated documentation even a not very complicated medical history will cover at least 100 pages of PDF documents. eCW lets us only import 3 mB which is nothing. The helpful suggestion by eCW support was that “we have to find some program on the internet” to decrease the file size so it can be imported. There are plenty of online programs that of course are not exactly HIPPA compliant. So on some charts we literally printed the whole chart on paper and imported the paper chart as there is no size limit. This is also very environmentally sensitive as we have too many trees anyway.

So the bottom line is we have accumulated by now about 50 CD’s in our storage cabinet that we were unable to import. Until we came up with a truly ingenious solution: We recently changed our fax to the online fax which is an 800 number directly into the SAAS server. But we still have the old computer sitting there with a fax modem. So we ended up faxing the PDF document from the old fax computer into the server fax. It takes about 3 hours per CD but it works. There seems to be no size limits on faxes.

I would ask you please commend us on this truly magnificent solution as we are very proud about our ingenuity:).

On a more serious note, pretty pitiful that we have to use such a stupid workaround. Does eCW actually have some kind of an explanation why there is a limitation on CD’s and not on faxes/scanning? This should have been fixed in the beta version.

Is anyone successfully utilizing the Ortho Navigator dashboard as a part of PHM?  I have attempted to get a user guide or some such, but this is all I received “The feature Displays a Risk Managment tab under Dashboard. When a care manager logs in they can see all tasks that have due dates unassigned or due for today. On the CCMR admin section under programs user can create tasks and under tasks you can add templates from HRA and care plan. Next, While adding surgery for a patient user has to select one of the programs. Finally, In the documentation section based on the program selected for the patient the tasks show up and for every task their respective templates. The care manager can then document it and assign due dates for each task. Turns on the Risk Management functionality in CCMR”    and an offer for further training .  There is no reference on the help hub nor on my.eclinicalworks.com.
HELP!
PS I have attached a screen shot of the dashboard for reference

Is anyone using eCW dental?  We have been using it along with Dexis for imaging since June and I’m looking for any tips/tricks, etc.

Thanks in Advance!

Hi!

I like to know what is SQL reporting ? and how is this used or implemented ?  what is the purpose of this?
Thanks
Padmaja

When I’m ordering labs (Treatment—> Labs—> Browse) I want the “Lab Company” drop-down in the pop-up to default to “All”.  Right now it’s set to our external lab company, but I want to also see our in-house labs without extra clicks.  I haven’t had luck finding a way to do this in the My Defaults button of the Lab popup, or in My Settings.  Any tips?

Also, “drop-down in the pop-up” is the name of my next single.

First time in almost 4 years!!
Wanted to share the joy!!
The attachment is a screen shot!!
:D

For anyone using 10e how do you install the required plug-ins? Do you simply open the EXE and go to Help > Launch 10e Url and they simply install at the pop-up? I’m assuming this is how it is designed to work. I’m also assuming it isn’t logical for the IT staff to login as admin on every computer and manually install these plug-ins? What if your clinic has hundreds of computers?

This is the solution we were told. The plug-ins must be manually installed on each computer as the admin. We’ve been going back and forth with eCW for weeks now and this is their final solution. We thought it might be our network/firewall so three of us tried to download the plug-ins from home (completely different network obviously) and the same thing happened, progress bar freezes when downloading.

How do the plug-ins install for you?

Thank you,
Tim

I have been sidetracked for a while with a serious health issue of my husband.

Back to CCM struggles…
1.  I have a patient who has Peripheral Artery disease
He has had multiple amputations
PAD is not on the magic list of CCM diagnoses.
I added it to his care plan, which in the past has taken care of this.
Now, it isn’t recognizing my customized ccm icd10

2.  why does the care plan disappear from view when I lock the note?
It is there if I look at it in virtual mode but if I just scroll through the encounters it is a blank, locked screen.

One of my customers is having an issue on -one- computer where one user sits.  It is reproducible with any ECW logon at that desk, even after the desktop computer was completely replaced. 

Upon selecting the payment to bring up “Receive Payments”, the person pokes the the drop down next to ‘publish to portal’, and selects “print Billing summary and Receipt”. 

This then causes an error, and then a print window.  The error hides _behind_ eclinicalworks, and is associated with the eclinicalworks.exe process, called “Web Browser”

The error is:
Cannot find
‘...:/Users/<username>/AppData/Local/Temp/<random name>.htm’
Make sure the path or Internet address is correct.

The file does exist in the temporary folder, can be opened up, and printed from there.  (even though the slashes are incorrect for windows)

My question - has anyone else seen this issue?  Additionally, does anyone have an idea of a workaround or the fix for it?  It started happening on one machine, which I reinstalled ECW upon.  That didn’t work.  I then replaced the computer with a new one, made from an image.  Another machine with the same image prints fine.  The _new_ machine then gave the same error.  Logging the user out, and logging in another user gave the same error.  Printers were completely replaced. 

It’s almost as if it is related to the network location of the computer.

The dust has settled and multiple letters of encouragement have been sent out from eCW. Our CEO has asked me to reach out to the eCW community and get your thoughts on the viability of eCW. I understand eCW monitors these posts and don’t want to put anyone in a bad situation but a discussion can’t hurt. Feel free to PM me if you want to stay anonymous.

Has your clinic considered changing EMR’s since news of the settlement? Were you considering changing beforehand and this news was the catalyst?

What are your thoughts?

Thanks,
Tim