ECW Users

Default to Custom ICD-9 Diagnoses instead of Ingenix?

2012-02-08T05:37:09-06:00

Hi! Can I set my custom ICD-9 diagnoses as the default instead of the Ingenix database? We create our own list because so much of what we do is the same code for different diagnoses (about half my diagnoses are 216.x, but each has a different name) . My assistants type in the code and it always defaults to a convoluted nondescriptive diagnosis that is too easy to click on when going fast.

Structured VS Non-structured allergies

2012-02-07T14:03:38-06:00

Pardon my ignorance friends but we just updated version 9 and now have these “structured” vs “non structured” choices for allergies. I have no idea what that means. Sounds like government and/or computer lingo to me, certainly not medical. Can anyone out there enlighten a Urgent Care doc like me on that issue?

IMO followup

2012-01-16T13:17:25-06:00

We are live with IMO for a week or two now and like it. It does not cost much (the cost is per year, not month) and is quite helpful.

I like that it pulls up a bunch of diff names for the same icd-9 so you can pick the more accurate descriptor. I bet it will be essential with icd-10. No more hunting for the wierder names to find the one the ecw knows.

The 2 negatives (one of which may be user error) do not outweigh the positives for sure.

1. the real time search truly crawls along. doesnt seem to bog the system down, but it dramatically faster to just type in a work and click ‘go’ than type in the word and watch 5-10 seconds go by between each letter popping up. yes one more click but still way faster.

2. The old way, when you opened up the assessment window, the cursor defaulted so you could just start typing as the window is opening and the text goes in the right spot and if you hit enter, then your list pops up.
Now, when you open up the assesment window using IMO, you have to wait until it opens and then click the text box to set up the cursor to allow typing. You cannot hit enter when done either, you have to mouse click the ‘go’ box. this makes IMO sig slower than the classic search for the routine stuff that we type all the time. This may be user error in the options/defaults/settings…. does anyone here know how to make the cursor default to the search box so you dont have to click it before typing? If that were fixed, IMO would be vastly superior for all uses.

If #2 were not fixed, I find that seeing a kid with ‘allergic rhinitis’ is faster when I click assessment > start typing ‘allergic r, then enter’ > then click allergic rhinitis from the list that pops up. Having used ECW, I know I dont need to type more than “allergic r” to put this icd9 on the first window/list. the new IMO way involves clicking assesment, waiting for the window, clicking the text box, typing ‘allergic r’, clicking ‘go’ instead of enter on the keyboard.

It defaults to remembering ifyou used ‘classic’ vs ‘smart’ search, which is nice if either one was consistantly superior.

Bottom line IMO is essential and awesome to finding the stuff you dont do all day. IMO is slower for the day to day routine stuff. If you can default the IMO to letting you type right in the box and let you type enter instead of clicking ‘go’, I would never use the classic search ever again.

Hope that helps. Hope someone can tell me that there is a default setting I am missing…..

Chris

Software design and the principle of least surprise

2012-01-12T09:40:42-06:00

There are hundreds of little user interface bugs that are apparently caused by eCW’s engineers writing their own code instead of using standard Windows facilities. Here’s the example that made me write today:

All of the little boxes that hold text in, say, the telephone encounter window are not using the standard windows text editor. This means that sometimes a cursor might not show up in the text, and you have to guess where you’re about to type. Or the arrow keys might not actually go forward or backward in the text, but rather might skip to another box of text (I think this is actually in the document update window; it is sporadic [i.e., sometimes the arrow keys work and sometimes they don’t] so I don’t know when it’s going to happen). Control-A (“select all”), which in every other windows program in existence marks the whole of the window for copying or deletion does not work in about 2/3s of the boxes, alt-backarrow, which goes back a word, doesn’t always work, alt-backspace, which deletes the previous word, does not work, etc.

[This reminds me of another non-eCW EMR I used about 4 years ago, which reimplemented the date functions rather than using the Windows facilities. Everything seemed to work right until Leap Day, when the button that we would use to show the last 2 years’ of visits crashed the application. It turned out that they had “rolled their own” calendar software, and were computing “2 years ago” by subtracting 2 from the year, and then trying to convert “February 29, 2006” into a date…. Moral: use system software when possible, it is more likely to be bug-free than hand-coded programs]

“It’s in development,” “It’s a bug” - Is this eCW’s response to everybody?

2012-02-07T10:13:33-06:00

Those are the answers we get for most of our 9.0 SaaS tickets.

What I don’t understand is why - if we are SaaS and eCW is hosting, why all similar clients aren’t having the same issues. Why aren’t all 9.0 SaaS clients on ASP12 unable to view scanned insurance vouchers? Why aren’t all clients receiving an error when clicking in the Progress Note that our physicians/clinical staff have to close hundreds of times per day? (for example..)

Today I was told that the upcoming service pack would resolve the issues and when I asked for release date, our SAM told me it was already out but had its own bugs and had been withdrawn(!!).

Just asking.

Improving eCW support

2012-02-02T11:10:30-06:00

I’m wondering if there is a way that we can pool our knowledge to think of ways to help improve eCW support.
Our staff spends hours each week creating tickets, contacting techs and trying to fix problems. I come in weekly to help with IT support and am usually working on a ticket or 3 at any given time.
We really like the product. eCW is a great eHR with many supurb features. The problem is that not everything works all the time. Or it works under certain conditions.

Some ways that eCW could improve:
- ability to schedule a time to work on a ticket
- updating tickets with the latest status: was the problem fixed? if not, when will it be worked on next?
- updating tickets with details on how it was resolved so we can fix it ourselves next time.
- contacting us when a ticket is resolved.
- listing contact information of techs working on tickets.
- not bringing the server down during office hours. (intentionally or unintentionally)
- techs could explain the fix they are about to try before they try.
- review the progress of a ticket and be familiar with it (talking to previous tech on the ticket) before calling.
- a FAQ/wiki/how-tos on their support site

I’d love to send this info on to eCW and actually work with them over time to help improve their support system. Anyone know who I could call to start giving them some feedback?

Do you have other ideas of ways to help them improve?

Thanks.

Ben

Medication lists contain duplicates

2012-01-26T18:15:56-06:00

Is any user aware of preventing this problem? The med list pops up with two versions of the same rx. For instance: protonix 40; protonix 40 mg po daily. Same drug but slightly different detail.

ROS Caret

2012-02-06T11:20:13-06:00

Does anyone have an issue with the ROS Caret not working when there is only ROS notes to pull forward? If I have notes and info in the categories they both pull fine but nothing pulls if there are only typed notes.

Interface with Community Wide Scheduling (Meditech) to eCW

2012-02-03T14:44:19-06:00

eCW scheduling piece is not good for our OB/Gyn department. I was thinking of going back to CWS and having an interface to eCW for the progress note/encounter.
Does anyone have anything like this? We currently have demographics/labs interface into Meditech bidirectional.

Thanks

Best Practice for Preventive Services

2011-02-12T10:14:14-06:00

I would like get some comments on whats the best pratice workflow in ECW for ordering and tracking Mammogram, colonoscopy DXA scan etc.
Right now we create a referral for each and also create an order in DI separately. There seems to a lot of issues with that.
>Colonoscopy is not a DI. It should be a procedure.
>When we create a DI order in progress note, it creates a CPT code and causes billing issues
>Colonoscopy is usually scanned into consults in pt docs and we are not able to attach it to DI order (because its not in Xray documents
>When you see the DI list for a patient, order date is what shows and its the date order was created and there is a place to check received date but there is no place to put the date it was actually done, so its causing confusion with alerts.

I would appreciate some feedback on this
Thanks