We have reports of notes disappearing. We took a look into the past notes and discovered the actual form isn't being used and free text into the chart is. The OV is then placed on hold and returned to at a later date, when returning to it the text is mysteriously gone. We've been trying to replicate this numerous ways but haven't been successful yet.
Has anyone experienced this type of documenting disappearing? Or any disappearance of text at all?
Are they just using an empty encounter or are they choosing an encounter that might have some text component in it? Do you have auditing turned on where you can see the audit trail in the Contributors List of the document?
Its a full OV with 8 forms. The particular form is a Procedures form but just has literally one giant edit field for a doc to quick text in. By looking at previously signed OVs' we can tell the doc is typing and quick texting directly into the note and not using the form at all. Now its reported that it happens "occasionally" so we haven't ruled out user error just yet.
I have one user with this issue periodically, but when using the auditing we are not able to verify that the user documented in the form at all. So I am thinking this is user error.