We updated to CPS 12.3.1 two weeks ago. We have identified a potential issue and I would like to know if anyone has reported or identified this same issue. Prior to our updating to 12.3.1 doctor or staff would open the Office Visit and begin their documentation process. Take the Vitals, ROS, PMH and PSH, FH and SH and then place the note on hold. Often an MA or nurse would do a "preload" first thing in the morning before a patient would get to the office and then the patient called to reschedule or no show and they would have to ask IT to File the office in error because they got a pop up saying "Cannot discard this document. It contains singed changes to the clinical lists." Since the update we have had two providers call to state that their office note is gone. We checked the File In Error view and nothing. We checked the audit trail to make sure the note had actually been created and it was. The doctor noted that he had completed the note except for his orders and prescriptions. His box is checked for Sign clinical list changes. Today we had another provider call in a panic that her office visit note from yesterday is gone. All the patient data like Vitals and ROS along with PMH/PSH and FH/SH was gone. We don't know if this is an added security right that we missed on the Release notes or if the check box function for signing clinical list changes is broke. Thank you.
Tara
We are on EMR 9.10.3 as of 8/27/18 but we noted in the prior EMR version 9.10.2 beginning in approx. March 2018 that our providers, various specialties, would sporadically report that their "notes" disappeared. We noted when the encounter was opened that the form components had disappeared and by re-adding the form components the text previously entered would reappear. I have a ticket open with GE currently. I have not been able to reproduce the issue. It seems to occur on both PCs with a local install, laptops with local installs and also in our virtual environment. I have added the form components into the nursing staffs favorites list so that they can re-create the encounter (which is made up of approx. 4-5 forms). I have some providers who are more tech savvy and they add the form components back in themselves. The majority of encounters that disappear are made up of VFE forms but I have had CCC forms disappear too.
We are on CPS 12.3.0 and we have had about 6 chart notes missing data in the chart note text. We have seen it in Vitals, ROS, and PE. The values are in the obsterms, but completely gone from the chart note text. We have our VAR and GE looking into it, but no answers yet.
Brian
This is scary. I'm interested if anyone knows if SP2 addresses this issue (or if there are any updates from you all experiencing the problem). Thanks.
Have you double checked to be certain that in fact if the clinical list changes were not signed the document was discarded? There is a report you can run for that.
Do you happen to know what report that is? I would love to run it and see for sure. We did check our File in Errors and the visit wasn't there so we are pretty sure that the Office visit note was actually discarded. Thank you.
If you have enough auditing turned on you could look at the contributors list and see which forms were added and if any show removed (and if they weren't removed they just disappeared). Adding them back should bring back the text as noted above. The other thing to check would be to get the SDID for the document from the DOCUMENTS table and then see if there are any rows for the update in the DOCDATA table, where the notes are stored. I'm not sure how they keep track of which forms have been used in an update.
Yes, it is under Reports>Medical Logic>Audit Reports (might be different in CPS).
You can use either All audited events, by user and event or Chart access, by user and event. Scroll down to "discarded document." You have to define a date range and then since you do not know the user, you can add them by LOC unless there are not too many. If you try to do too many users, it sometimes crashes the application (especially during high usage times). Let me know if that works.
Thank you so much for letting me know where this report is located. I appreciate your help.
Brian - we are 12.3.1 - and we just got notified by a provider that her note opened this morning had 5 forms disappear and now when the Vitals form is put back in the line up the data is missing. It is in the Clinical List but not in the physical note/form. 1 step forward and 10 steps back.