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Will be interesting to see how Dragon does in the future with all of the new AI technology coming to the market.

No but I've seen the ads

That was a big problem and the scripts could not be sent.
Had to Archive it and write a whole new prescription.
Now on V12 so will see if that still happens.

I do believe this is what our OP is talking about:

Dreamquest Mini Desktop from Amazon

I'm afraid I cannot recommend this computer. For one thing, the price is absurdly too low for a device with the specs it has. The NVME drive, alone, is $199 and they want that for the entire device. This sets off my "too good to be true" alarms. Further, I have never heard of this brand before.

If you are looking for a small form factor computer that takes up little space, I recommend going with a well known and trusted brand. Yes, it will cost a bit more, but you are guaranteed to know what you are getting and the warranty is way better.

https://www.dell.com/en-us/shop/des.../spd/optiplex-7010-micro/s002dacomffusvp

FULL DISCLOSURE: Note that I come from a business background having worked at places like Corning Fiber Optic and General Electric Global Nuclear Fuels. Any recommendation I give will always be from a business standpoint that includes considerations such as proper software licensing, warranty, brand confidence, and so on.

JamesNT

For those that would want to use the Recommended Improvements feature, a word of caution:

* You should practice writing down your recommendation/request and then reading it back to ensure it makes sense.

In my years as a developer I cannot begin to tell you how many times I got requests for features on whatever software I was working on and I had no idea what the user was talking about. People used 7 word sentences to describe a feature that took 2 paragraphs to explain once done.

Your request does not stand a chance if the dev team has no idea what you are talking about. Be specific. If specifics make your request to ungainly for the Recommended Improvements thing, then come here and bother BrotherJon. As for those who are not a member of this forum, woe unto them.

JamesNT

When a child goes from the 0 to 2 year old growth chart to the 2 to 20 year (or whatever year), the results aren't that good at the two year visit. I asked ChatGPT with a long of prodding and debating. ChatGPT 4.0 (it has to be 4.0) created a 0 to 60 month in color growth chart. I was then able to say 7 lbs at birth; he was 11.2 pounds on 2/7/24; 14 pounds at 4/7/24 and he created the chart with the plotted points. Same thing withthe bilirubin nomogram. Sometimes you have to create a bilirubin nomogram or a growth chart with only bilirubin numbers or weights and times. Saves tons of time.

Bert, I can not remember a time where it crashed on Sign Off or Sign It when closing the chart.

Beagle, the most amount of crashes I see now with V11.5 is when I have more than one thing in the Write Orders stage. It doesn't happen all the time but very frequently. If you open 2 tabs say the Labs and Imaging with orders in both, so there are 2 orders in the Order Queue then it is likely going to hang up when you hit print. The program has to be shut down and restarted. There is no way to get it back to the chart or past this window without restarting the program. I have had tech look and there is something hanging up in the Windows portion not AC, so the problem does not show in the crash log of AC.

Bert, I rarely look at the charts, not many pediatric patients for me. Diagnosis memory happens occasionally. I find problems with the diagnosis when there are too many diagnosis saved in the chart. I think the max is 100.

koby, I rarely lose a chart when it crashes. For me I would say less than 10% of the crashes does it not work. We also write down the vital signs on an intake form, just in case. Old habits are hard to break.

FAQs:

Question: Why do EMRs like AdvancedMD, Dr. Krono, etc. place a limit on how many transactions per minute/hour/etc. you can call on their online API?

Answer: Because they all host their stuff in the cloud and Amazon Web Services/Microsoft Azure charge for bandwidth. Allowing someone to upload 200,000 patient records in a few minutes, and allowing for the bandwidth to do so, means someone gets a hefty bill at the end of the month. Other reasons include the fact that they have limited compute power for the database servers and probably a few thousand other clients all pushing/pulling data. Therefore, you (and they) are throttled so you won't choke things up and cost the EMR company in question lots of money.

Question: How many different EMR databases are you familiar with?

Answer: Amazing Charts, PrimeSuite, NextGen, EMDs, AMS, eClinicalWorks, Intergy, Office Practicum, Practice Now, AdvancedMD, AllScripts, Care360, Isalus, Lytec. Note that some of those you never get the actual database itself but an export from the vendor's cloud.

Question: How many languages do you write code in?

Answer: C#, Visual Basic .Net, Visual Basic 6.0, and Transact-SQL. Back in my college days you could throw C++ and Java in that mix, but I haven't used those languages in almost 20 years.

Question: Do you support Apple Products?

Answer: No. Apple sucks.

Question: What do you think of the recent ransomware attacks?

Answer: I think it's a combination of many things. In some cases, the bad guys are just that good. In other cases, you have IT managers that just need to be fired or execs that need to be replaced. They care nothing for IT and don't want to budget for it. So, you end up with these big companies you think would know better but they aren't using Multi-factor Authentication, they still have end-of-life systems in full production with no support, and not a soul in management cares.

Question: Why do you like working with AC so much?

Answer: Because it is the only EMR that has not gone totally bat sheet crazy. The rest have overly complicated database designs, complete disdain for their users/customers and have horrible support. Further, the ease of use of the AC database for 90% of what anyone would want from it speaks volumes. This isn't to say AC is perfect. They aren't. And they have started doing some things I find distasteful, but AC is still one of my all-time favorites to work with. I have other favorites, mind you, but AC is on up there.

Question: What IT functions do you get paid the most money for?

Answer: Custom software development, database conversions, and Clustering/High Availability setups. I also do pretty well providing onsite/offsite backup solutions.

Question: What is the most expensive setup you have ever put together.

Answer: To date, a Hyper-V failover cluster with in-guest SQL Server Cluster and in-guest FTP Failover cluster at the main office, Distributing File Services so one file share is replicated to 5 branch offices, each branch with two servers in Hyper-V Replica, and their own SQL Server with SQL Server Replication replicating the database in the main office to each branch office. Therefore, each branch has their own local copy of the data be it file share or SQL database and every change made in each office is replicated to all the other offices with the main office being the primary copy. I'd say the final cost is somewhere between $250k - $300k if I had to put a number on it. I learned how to keep up with mileage on that project.

Question: What is your biggest IT mistake in your career.

Answer: Not starting my own business sooner.

Question: What made you decide to write this post? I mean, some of it is useful, some of it is your opinion, and that one question with the long answer is just you showing off how much you know.

Answer: It's 9:30pm and I'm waiting on conversion program I wrote to finish running and I was bored.

JamesNT

Side note: I do wish you could have height and weight percentiles on the most recent encounter tabs to quickly scroll back through trends.

I am curious - for anyone that uses the Order system, I'm hoping that maybe I'm just missing something......

If a provider orders an x-ray, and you CAN reconcile the imported item to the order and select complete:

1) If you change the text it changes the order; do you just use it like a log and keep adding lines?
2) There isn't a way to see the reconciled item directly linked to the order is there? I would like to be able to essentially attach it, and then as a unit I could forward something if I had questions or concerns (ie Dr XXX did you see this result from this order? Any next steps on this?). I just wish there was a way for it to be physically attached in some way. Like what's the point of reconciling, ya know?

So - I sorta.......just told her we couldn't. I hate the idea. It's really bad practice. So I just said no.

We don't currently, but I have been meaning to try the Updox patient scheduling option. I'm just nervous for what that would end up looking like. We like to have a lot of control over our appointments.

I agree with Bert. Writing that data to the database should not take that long. It would be interesting to see what the program is really doing behind the scenes of some of these long operations.

JamesNT

Thank you all. Misery loves company. I will see if it is possible for our IT to arrange access to NewCrop independent of the EHR. If it makes you feel any better, our problem is actually worse. Portions of the med list, and sometimes the entire med list will be discontinued just by opening the chart. I now have to go back to my last note and recreate the entire list in the prescribing section from the list I had include in the note. (As an aside, I have habitually put the med list in the note twice; once at the start of the visit, to tell me where I started, and once at the end to show what changes I made. Our EHR does not have the capability of tracking prescribing history). Sometimes, even then, the list will be deleted while I am still active in the note. Med reconciliation now takes me at least half of the visit.

Volunteering for beta v12. Someone relay to AC? I sent a tech support note but might get lost in the fray. We forum members should make good beta testers.

I'd like to bump this back up; anyone use this part of Amazing Charts?

I do not use UpDox. I never have used them and hate that the patient portal is linked to them.

I use a Brother MFC machine currently on a MFC-L5850DW. We have had 4 Brother machines in the past almost 20 years. This current one is almost 4 years old. I use it for faxes in and out and have a couple of scanners for stuff that comes in through the mail. There are other posts on the board about using the Brother machines in place of UpDox. I think the best post goes back several years and was posted by Leslie.

For that price I could buy a new machine every month.

just my 2 cents

We don't have interfaces with any labs. Only faxes.

Besides, we despise Quest. They have ruined our lab system in Bangor/Brewer.

Yeah, I would have liked some kind of summary of changes in the document. I essentially had to agree to the new EULA since I could not access AC without it, right in the middle of a workday, with patients waiting...

I'm very interested in learning more!

You might be glad you have a server based EHR when you retire.
The cloud always seemed pretty expensive to me, and in our area, quite unreliable. The reliability problem has improved in recent years.
My wife and I retired and closed the practice about 2 years ago. No one wanted to even assume the practice, let alone buy it -- local hospitals are paying double what we could pay ourselves, and even they seem to be having trouble recruiting family doctors.
We still have to maintain the records, of course -- but Amazing Charts lets us keep our server and use it for records storage without paying anything --since we aren't entering new patients or prescribing meds, we don't even pay the annual maintenance fee. The clout based systems I have encountered are not generous in this regard.

at Boston ACP, visited Nuance booth. Colleague at JHH community physicians tried it then changed to “Abridge.” She much prefers Abridge. I contacted Abridge, placed on waitlist just to have someone speak with me. I suspect they’re only interested in the big institutions. Also, when filling out their questionnaire- only large EHRs listed- Amazing Charts was not on list. Pretty soon, AI scribes will be ubiquitous. I wouldn’t mind starting now. Anyone using one with Amazing Charts?

Amazing Charts- My colleague gets permission from her patient, leaves her phone on, speaks the encounter- gets a note and patient gets a summary- I suspect coding and billing is done as well. I’m going to check it out. This tech is to current EHR what the current EHR was to paper charts. Hopefully someone will keep it affordable for small practices.

Gino

I am cloud-based. That doesn't happen to us.