V11 Note: Recent Enhancements & New Functionality

Webcast Presentation

Enhancements to the V11 note that allow it to be used as a clinical summary compliant with Meaningful Use.

    Originally aired: Friday, November 14, 2014

    Presenters: Elise Brault and Cece Teague

V11 Note Enhancement Webcast==Webcast==

Q&A

Q: Since this is one note, how do you separate out note section from not displaying in the clinical summary? I.e. we do not have a physical exam section in our CS.

A: When building the Note Output Template for the note being used as a clinical summary, you can create more than one output. For each output, you can change the document type to the one that is appropriate. The clinical summary output, associated with the clinical summary document type, may exclude the physical exam section. Another output can be associated with a different document type for the note recording the full exam in the patient’s chart. For example:

Q: We are currently having problems with place holders in V11 note. The information does not fill in and the placeholder renders in the note. Are others seeing this same issue?

A: I found only one known issue concerning placeholders: ~Mr/Mrs~ Ln renders as r/Mrs Ln

There is not a scheduled release date for a fix. If this is your problem, I would log a ticket with Allscripts so they can attach your case to 05269362 and you can be kept in the loop for the fix.

Here are some common hints concerning placeholders:

• Make sure the ~V is displayed in the Positive Text and/or Negative Text properties as a placeholder for the text value that needs to be entered. For this to work, the three underscores ("___") need to be in the Display Name property field. The ~V text entry space can be used with Medcin Fields and Text Fields.
• The ~U is placed after the ~V and before the desired units of measure in the Positive Text and/or Negative Text properties, like this: ~V[space]~Ucm
• The ~M is used to specify the position of a "modifier" for a Medcin item, when applicable. The positive text for each control will render where the ~M placeholder exists in the group control.

If you cannot resolve your issues we suggest that you put a ticket in with Allscripts.

Q: If you add a word to the spelling dictionary is that on the database or the local pc?

A: The following is information from Allscripts:

“In a non-Citrix environment, each workstation has a userdic.tlx file in the system32 directory on their local workstation. If a user adds a user defined word to the dictionary, this is where it is stored. They will need full read and write permissions to this file, and the Read Only attribute on the file cannot be checked. In a Citrix environment, the userdic.tlx file is stored on the Citrix server, so there are a couple of reasons why a user won't be able to add user-defined words. - It is not possible to give individual users full read/write permissions on a file like this through a Citrix environment. - The file is not meant to be shared by users. Multiple users would be editing the same file on a citrix server. - If a user is connected to Citrix Server #1 and adds a user-defined word, the next time they connect they may be on Citrix Server #2 which has a different user-defined dictionary and won't have that same word that was added. If you would like, you can check with your citrix admin to see if they have a workaround for Citrix support. It is not possible to edit the main dictionary through the back-end”

The following is additional information from users on ClientConnect.

“We’re running 11.4.1 HF4. Updating the UserID to 0 makes that word available to everyone. We’re using Citrix. I did find the file C:\Windows|SysWOW64\userdic.tlx but the new keyword was not in there.” “I added a word to the dictionary in note and it did not show up in the file but it is now in that table in our Works DB” “We monitored our database pulls when opening a note, it pulled that table every time we opened a new note. What table did you see it being pulled from? SpellCheckUserDictionary"

Our internal testing, in a non-Citrix environment, found that a user defined word added to the dictionary is saved on the local workstation. We are unable to test in a Citrix environment.

Q: I agree this a good function although the spell check cannot be removed and it has trouble with medical terminology. Any suggestions?

A: Unfortunately, no. The dictionary is improved for Allscripts Clinical Note which uses Stedman's Medical Dictionary, instead of Spellex provided through Touchworks. However, that only helps if you use ACN...