Loss of Precompleted Notes and Macros

Major bummer for a handful of dedicated CIS users. For convoluted reasons, precompleted notes and macros that had been created on now defunct versions of PowerNote can get lost. The probable issue with the loss of the precompleted notes is that they were likely created on older templates that had been revised over time. We've seen folks lose notes that were created on the earliest templates.I am learning that the system can be quite sensitive to changes made in the content and code. Cerner, our EMR vendor, recently recommended:

Ensure that the precompleted note or the macro was not created before a recent content load. If new PowerNote content has been taken since the precompleted note or macro were created, there will be viewing issues. They were created under older content and a different structure for the portions of the note (paragraphs, sentences and terms). Therefore, when trying to use the precompleted notes or macros with a new structure, there is a mismatch and some of the terms that were there before are no longer there or have been moved around. In order to resolve the issues, the macros and precompleted notes will need to be created and saved again.

An alternative explanation may be that the precompleted notes are shared and accidentally deleted by another user. Unfortunately, there is no way to back up precompleted notes. Cerner's answer to the difficulties with macros and precompleted notes is to create a compendium of auto-texts that would serve a similar purpose. These are not dependent on content or template format and can be used across all PowerNote Templates or in Clinical Notes were you to work from that screen.

I honestly wish I had better news.

Auto-text re-update (if you read the first version this morning)

Last week, I discovered that I was able to quickly build about 16 procedure forms that Pain Management had requested over three years ago (!) using the auto-text feature. By simply copying and pasting from Word documents, I was able to circumvent the creation of these fill-in-the-blank forms via PowerNote and have them appear as they always had in the paper world. Great stuff that I expect to apply to a variety of form-based requests. However, there is a catch.

When we first introduced auto-text, suggestions were made to begin each shortcut with a designated symbol, e.g. your initials, the letter z, or a period. I certainly didn't jump up and down to get the word out, so a number of folks have used logical abbreviations like "chol" for a cholesterol-related text. For myself, I've been using the letter z pretty seamlessly. Well, when the pain management forms were posted, they were saved across the system such that they will appear for all users of auto-text. Since they are system-based, they can't be deleted from an individual's list of auto-texts. Well, understandably, this created quite a nuisance for a number of folks. Thanks to Julio Martinez, we realized that, if we start the specialty forms with ~, these will sort to the bottom of an alphabetical list and so you will no longer even see these forms unless you are looking.

If you read the first version of this post, I suggested you rename your auto-text shortcuts. You no longer need to do this. Continue saving as you wish, though I'd still recommend starting with a symbol so that you can view your list, or even create a series of lists, each summoned by a particular symbol.

If you want to check out how you might want to create a form, check out what we've done for Pain Management. For the next few days, they will begin with "pm", though by early next week, they will start "~pm". Here's what you do:

Go directly to Clinical Notes, right-click on the open field and select Add, then type pmAxNB to add the Pain Management Axillary Nerve Block form to the page. From there, hit the Insert button on their keyboard in order to overwrite the lines and fill in the blanks.

As always, feel free to post a comment, anonymously or otherwise, or shoot me an email.