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Extremely slow EMR after server reboot

November 1, 2018, 1:49 am
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Yesterday was the most frustrating day with Eclinicalworks. The EMR was running very slow so we rebooted the server and found it to be CRAWLING slow after server reboot. We could ping the server with no latency. We placed an urgent support ticket in the morning and it took us over 1 hour to accomplish each office visit note since it was taking a LONG time to register each click. There was a long pause after each click for the EMR to recover and it gave all kinds of errors as if the database was not proper.

The guy on the support line was not helpful at all. He said he was just filling in for someone and had no clue. He said his supervisor would call but nobody called. Apparently, I was told that support was working on the server but I did not see any activity and we had absolutely no results by the end of the day and it only got worse.

If I were to start with a new EMR today, what EMR would be a good one to switch to? I am assuming I would have to start as a new practice with a new EMR to avoid importing corrupt data into the new EMR. My office staff is suggesting Practice fusion. I have no clue what EMR’s are out there and which ones are good but it seems like if I do not have a functioning EMR today, I might have no choice but to switch today to avoid losing revenue going forward.

Any help in this matter will be highly appreciated.

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PDMP in V11 (Appriss)

November 1, 2018, 8:27 am
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Anyone using the PDMP product in V11 yet? (Appriss Narxcare controlled substance report query)

Curious to see if it allows RN’s/MA’s to run the query while rooming the patient.

Also wondering if logging is working as expected.

Thanks in advance!

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Drug Ordering Interface - No Solution??

November 1, 2018, 10:17 am
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In our office we dispense drugs (injections mostly) and have been working on setting up an ordering interface between ECW and our Lynx Mobile system (McKesson). Ideally we would have demographic and ordering information coming over, similar to a lab interface.

At the beginning of this project I assumed it would be a simple ORM interface but it has been 8 weeks now of going back and forth with Mckesson and ECW. ECW tells me they simply can not do it. I have spoken to multiple people/engineers on ecw’s side but still don’t feel like I have received a satisfactory answer - its just “we cant do it” The McKesson rep agrees and has sent multiple test files to show for mapping

The only solution we have been able to come up with is an outbound SIU interface that creates the order in Lynx Mobile when a patient is scheduled in ECW, this presents another set of problems but its the best both sides can agree to. McKesson does have another site using this solution currently.

Has anyone else tried to create a drug ordering interface with ECW and if so, what was your experience? It blows me away that ECW has no solution for this, our McKesson rep agrees. Most EMR’s interface with Pyxis systems, does ecw not?

If it does not, that is a huge hole in their compatibility. To the point it is making our physicians and COO rethink if ecw is going to be right for us as we gro

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Registry report with Lab results (positive patients)

November 2, 2018, 9:04 am
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Hello All:  I need to run a registry report with gonorrhea chlamydia test positive.  Quick turn around help would be much appreciated.

What I did so far?
Using the Lab/DI/Procedure tab- Lab type and Date Range, i got total number of patients.
BUT, it does not give me subsets of patients when i select either of positive, negative, etc.
I need to get positive patients only.

Thanks.

Kumar

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Automation??

October 8, 2018, 12:03 pm
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I have been using ECw since 2009.

I know there are features that I might not have enabled.

So here is my request.

WIth all the insurance needing HEDIS codes, BMI, etc - is there anything that will automatically add some of these codes (CPT and ICD) for me?

I have templates created to assist and a superbill created however they want it to magically appear.

For example, MA enters ht, wt and BMI is calculated.
Is there anything that will automatically put the appropriate ICD code for that BMI?

I can create a clinical rules engine however it only activates after DONE and my database is shared amongst various practices that will not use this option. so they will have another click to by pass.

Another request is when the PHQ9 is completed for it to populate the CPT.

Just trying to save the docs some clicks!

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future vaccine orders

November 5, 2018, 6:22 am
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How does your practice enter orders for future vaccinations to be given at nurse visits?

A situation we encounter frequently is that a child arrives as a new patient from outside the US either 1) with vaccine records from outside the US that need to be interpreted and entered, which is rarely possible on the same-day visit, 2) without vaccine records and we draw titers, or 3) without vaccine records and we restart the vaccine series.  Once the historical vaccines are entered or the titer results are received the provider needs to order the vaccines that are due. 

Currently providers are entering vaccine orders in a Progress Note Follow-Up field (ie 2 weeks: nurse visit for MMR-V); or, when the nurse enters the historical vaccines, she sends a TE to the provider saying that the vaccines are entered and that 4y vaccines are due, and the provider responds with the order to give MMR-V and Dtap-IPV at a nurse visit.  Both of these workflows don’t make it easy for the nurse to locate the provider’s orders, the nurse needs to scroll through Progress Notes and TEs to locate what the provider wrote.

We are hoping to avoid having to ask nursing staff to grab a provider on the floor to input the vaccine orders at the time of the nursing visit.  Looking forward to your suggestions and input!

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list of specialists

September 18, 2018, 3:36 pm
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Whats the best place to document the lists of specialists and vendors as per Medicare annual wellness visit requirements? I’ veben keeping it under PMH but wondering if there is a place specifically designed for this (eg: Circle of Care, the Care Team heading - which I only see under medical summary).

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Clinical Rules Engine

November 6, 2018, 12:29 pm
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I’ve seen several posts here about using the CRE.  I have been back and forth with ecw trying to get the same options that I see here.  I am on 10e.

On my exe version, I don’t have the option to “add to assessment”.  Support is telling me that is not available in 10e yet I see posts here that say some people have that option.

On my browser, I don’t have cre at all.  Ecw support is saying it is not available in the browser version yet I have seen screenshots on here from a browser.

Is anyone willing to share a screenshot of their 10e (exe with Add to Assessment or browser with cre) so that I can maybe get ecw to help get these features for me?

I have searched my item keys and it looks like all are set correctly.  I’m not sure what we’re missing.


Thanks!

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HEDIS Dashboard

September 29, 2016, 12:51 pm
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Do any of health centers have the eCW HEDIS dashboard?
If so, what is your experience with the dashboard (pros and cons), how useful is it for meeting the HEDIS measures, or reporting?
Any feedback health centers have would be greatly appreciated!

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Converting to Cloud Based versus In house Server based - Version 11 and fax solutions questions

November 7, 2018, 12:49 pm
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We’ve been with ECW since 2005.  Looking at switching to ECW cloud host server versus being in house.  Several factors involved in this - cost of servers, IT help is off site and limited in resolving our ECW issues, multiple off site satellite clinics, etc.  I am the one who gets stuck doing all the upgrades, fixing the crashes in house, etc - I want my life back and this way ECW does the patches and fixes the system if/when it goes down.  Doctors want to be able to use ECliniMobile on Ipads while at hospitals and other facilities - 50+% of our patients not seen in clinic as we are a surgical practice.  Cloud based allows them to go into our records from any computer as well without a remote connection.  We have fiber optic internet so we are also wondering if the slow issues with version 11 would still occur.

Questions that I need help with before we go to this option.

Version 11 - does the EXE version still work like the version 10 does.  I absolutely HATE the 10e version for billing data entry as I cannot tab thru my screens, must click with a mouse.  It is absolutely paramount that I still get EXE version on cloud.

Fax solutions - if you go cloud, does the analog fax still work or do we need to go with eFax Solution?  Is this a huge cost to change to?

Has anyone else gone in house to cloud?  Pros and Cons please.

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Patient Arrival Delay in the S Jelly Bean

November 7, 2018, 11:35 am
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Hello eCW users,

Has anyone experienced a delay between marking a patient as arrived at the front office and when clinical staff is notified through the S Jelly Bean? We are seeing about a 5-8 minute delay before providers see that their patient is ready. Providers have reported that they are refreshing their screens and we have checked that all settings are properly set.

Thank you!

-Lila

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Primary pharmacy report?

November 7, 2018, 6:38 pm
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I need a list of patients who use a certain 3-letter pharmacy, since we are severing communication with them.  (Yes, it is that bad)

I don’t see any registry item to run a report.  Is there some other way possible?

Thanks

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eClinical Mobile for staff

October 10, 2018, 8:09 am
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What, if anything, are you staff using eClinical Mobile for?  In the past, we had some nurses set up to see schedules, telephone encounters etc, but they could not do any documentation.  Has this changed?  I didn’t think anyone except (paying monthly) provider users used eClinicalMobile,
thanks,
karen

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Script Issues/eCW Errors in general - Does anyone else have these or are we the only ones?

November 8, 2018, 1:15 pm
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Several times a day we have users report script errors of all kinds. The one that is white screen and says script has stopped, they gave us something for to put on peoples computers and was told it “hides” the error so they don’t get it anymore. They continue to get the grey script errors - we have seen these in medication reconciliation / M beans / collections etc. Our billing office has to log out of eCW and lunchtime or they will get memory errors by about 2pm. We have gotten several dll errors, white screen and blue circles. We have worked for over a year on this and still no resolution. We are being told that once we go to 11e we won’t experience these issues anymore.
Can anyone speak to this and does anyone else have these kinds of errors? I can hardly believe that we are the only client experiencing such issues.
Any input is much appreciated.

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Where Do P2P Documents Go?

October 12, 2018, 9:17 am
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If you do not manually associate a P2P document you receive with a patient name, it seems to “disappear”. 
Does anyone know where these P2P, apparently unfiled/unassociated documents go? Is there a folder for these that is user accessible?

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previsit Med rec

November 8, 2018, 6:50 pm
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What’s the best way patients can review and reconcile their meds before I see them in the exam room.  Something they can do in waiting room, as well as complete my standard Review of systems.  I tried the portal but seems rather buggy.  And I’m too cheap to pay $25 per month per provider for another service that costs money but doesn’t help my bottom line.

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Clinical Rules Engine

November 6, 2018, 12:29 pm
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I’ve seen several posts here about using the CRE.  I have been back and forth with ecw trying to get the same options that I see here.  I am on 10e.

On my exe version, I don’t have the option to “add to assessment”.  Support is telling me that is not available in 10e yet I see posts here that say some people have that option.

On my browser, I don’t have cre at all.  Ecw support is saying it is not available in the browser version yet I have seen screenshots on here from a browser.

Is anyone willing to share a screenshot of their 10e (exe with Add to Assessment or browser with cre) so that I can maybe get ecw to help get these features for me?

I have searched my item keys and it looks like all are set correctly.  I’m not sure what we’re missing.


Thanks!

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Eclinicalmobile schedule view

October 30, 2018, 8:53 am
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On my phone all the schedule listed under me - the physician- also includes everyone of my patients scheduled for bloodwork (we draw in house).  How do I get them off my schedule view.  They don’t show up on eclinicaltouch, just the eclinicalmobile app.

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HEDIS Dashboard

September 29, 2016, 12:51 pm
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Do any of health centers have the eCW HEDIS dashboard?
If so, what is your experience with the dashboard (pros and cons), how useful is it for meeting the HEDIS measures, or reporting?
Any feedback health centers have would be greatly appreciated!

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Faxing progress notes upon locking?

November 10, 2018, 1:14 pm
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On my multitude of notes from the national users conference, I wrote down “the ability to automatically fax progress notes to referring provider upon locking in V11”.  Was I wishful thinking or did I hear this at one of the presentations?  We upgraded to V11 this weekend and try as I might, I cannot find it.  If anyone sees (or knows about) this option, please point me in the right direction.  Thank you!

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