AUTO NOTES USERS....READ BEFORE UPDATING

[savvy]

Greetings,
If you are a current Auto Notes user and have not yet updated to version 6.4, I suggest you in some way copy your current setup configuration, even if it means writing it all down.
If you do not do this, you will be much less unhappy than if you don't ( may I add you will be unhappy....just less).

My personal experience may be different than yours, but I will share it in hopes that it may help others become less frustrated.
I have/had extensive notes with many drop down selections.
Today, after a procedure, I selected Auto Notes as I always have.
The initial list of Auto Notes appeared, I selected my procedure: Delivery.
Generally, what now appears is a long list of individual drop down selections.
Today there was no such thing, just a blank box.

It turns out one must recreate the Auto Notes in the Setup.
I haven't yet begun to do this, but it doesn't look fun and it seems to require time which I do not have currently.

Once I begin recreating my notes I will let you know.

[jordansparks]

Hmm. Two steps forward and one step back.
1. I thought the old autonotes were so hard to use that nobody would have set up extensive ones.
2. There seemed to be a lot of demand for something better.
3. The old autonotes did not meet our quality standards and I probably should not have allowed them to be added in the first place.

I'm very sorry for your hassle. I have a feeling that not many other people used the old autonotes. But I stand firmly behind the quality of the new ones. Yes, I know we need multi selection. It's coming.

[savvy]

My above remark was not intended as being complaining.
Just a stern warning to others so that they don't fall into my pit, I prefer being alone.

I guess that is the price one pays for running on the edge.

So here is my question:
Is it possible to create or modify one's Auto Notes file on one computer and transfer just that component of OD to another computer database; ie from home to office?

[jordansparks]

Wouldn't it be better to use logmein?

[savvy]

No

[savvy]

OK, after an hour and a half of removing the commas and line iteming all my previous variables, I tried to copy what I had previously created.

Here is an example of my notes for an implant and a filling prior to the "revamping" of Auto Notes

1) Patient presents for restoring 4.3 mm Implant Direct implant w/ Nobel Biocare Healing Cap placed by Dr. Pia Lodberg. Removed Healing Cap, placed Nobel Biocare Esthetic Abutment 1 mm Finger Tight; PA to confirm seating Torque to 35 N; reconfirm torque after 5 minutes Covered screw w/ cotton Cemented Abutment Supported Crown with GC FujiCem Checked Occlusion and polished The patient's next scheduled appointment is for recall in 1 week.

2)Excavated and removed all caries. Confirmation obtained using Clearfil Caries Finder. Etched cavity prep with 37% phosphoric acid for 20 seconds. Rinsed cavity prep with water spray. air dried using three 1 second air blasts. Placed Clearfil SA Primer in prep. Air dried. Placed Clearfil Photobond, thinned using air, light cured for 20 seconds.Placed Vivadent Tetric Flow composite in prep and cured for 40 seconds. Smoothed and polished Checked occlusion

Here is the new Auto Notes:
1)
Implant Direct, 4.3mm, Dr Pia Lodberg, Removed Healing Cap, Esthetic Abutment 1 mm, Finger Tight; PA to confirm seating,Torque to 35n, Covered screw w/ cotton, GC FujiCEM Automix, Occlusion and polished,1 week

2)
37% Phosphoric Acid for 20 seconds; rinsed w/water 5 seconds; air dried 2 seconds,Clearfil SA Primer for 20 seconds; air dried 2 seconds,Clearfil Photobond, 20 secondsTetric EvoFlow,40 seconds, Occlusion and polished

Which one is more clear.?
What seems to be a factor is that the new version doesn't seem to allow adding of other info while creating the notes. If the information one wants to add isn't already listed as a prompt, one must alter the note after it is completed. Also, it doesn't seem that one can skip over a prompt if it isn't indicated.

[Rickliftig]

Savvy -

I think if there was ever a legal question, both would be acceptable (although who knows how the law really works?). In my own case, I often will add verbiage for myself (or the patient) emphasizing certain points ie) "the patient was told that without treatment, their tooth would fall out." Since I rarely say the same thing in exactly the same way twice, I have opted to dictate into Dragon Naturally Speaking 10.

As a side-note (I think I may have mentioned it here), there was a doc in a neighboring town who was brought up before the State Dental Board on charges (or whatever) and part of their citation was that all of his notes were identical! Take that for what it's worth. That could be the Dental Board flexing its will in order to drive a point home. i do not believe that it s illegal to write identical notes <G>.

To return to the topic, your notes are highly detailed and probably far above the average dentist. Good work!

[savvy]

Thank you for your comments.
When using the previous system, one could change and customize the stock answers on the fly.
The new way , that can not be done...at least I can't.
My only point here is that generally if one would like to improve one's notes,
One generally would want to go from example 2 to example 1.
Not from example one to example 2.

I put a lot of time,(months!), learning how to and tweaking the previous Auto Notes.
Now, I have to start all over.
Not only that, my staff has to relearn it.
That's a HUGE deal because it took so long for my staff to get on board with using the notes.
Now, they have gone back to placing much less detailed notes.

I'm sure there will be an arguement that I haven't given this new way a chance, but that isn't the point.

If it sounds like I am complaining...I am.

This could happen again:
Some of you might be using a feature that many are not.
An update appears that "betters" that feature......for those not yet using it, but screws up the feature for those that are.

There should be some way to not accept that feature of the update.

[fmr]

I totally agree with savvy. We too put a lot of time and training into the autonotes! It only needed to be tweaked, not replaced.
Yes, it was difficult to set-up, and I assume many of us put in the effort to make it work - that's why it shouldn't have been replaced! I'm trying to train my staff on entering inventory. That isn't any easier set up and follow, by the way! Now I've got them not taking it seriously because who knows if it'll be changed too. Is there anything else the "majority" doesn't like that may get replaced? Could there be a way not to accept a new feature?

I apologize, my staff is so pissed off and of course it's all my fault - I'm just venting out my frustration................

Thanks

[atd]

Also, it doesn't seem that one can skip over a prompt if it isn't indicated.

In the old auto notes you could pick and choose which items you wanted to fill in and in what order. If you didn't fill in a text box then that section was skipped - this worked really well for our exam auto notes because not every field would apply to every exam. So are you saying that in the new auto notes you have to choose an answer to every question?

When using the previous system, one could change and customize the stock answers on the fly.
The new way , that can not be done...at least I can't.

I also liked that with the multiple choice lists you could still type in your own answer if what you wanted wasn't listed. Is that no longer an option either?

Anyone out there that is happy with the new auto notes? Are there any changes planned based on the comments on this thread? Just wondering if I should wait to upgrade or if it is the way it is and I should make the change now. I have several auto notes setup and a lot of fields to recreate.

[fishdrzig]

I was going to setup autonotes using the "new overhauled" version but will wait and still continue to copy and paste my notes from my MOGO program running in the background. I think Jordan is working on it though.

[jordansparks]

Sigh. OK, we can't go backwards. The only option is to move forward. From what I'm hearing, this feature is currently unacceptable. Therefore, enhancements will immediately be made in version 6.4. Probably:
1. Automatically convert the commas to carriage returns.
2. Allow skipping prompts that do not apply.
3. Allow freeform text in addition to the pick list while still in the prompt.

In addition to the above changes, we could consider the following enhancements to try to make it better than the original:
4. Categories of notes
5. Date
6. Multiple selections from pick list.

In savvy's examples, I am a little confused by why his "new" version is so sparse. The big text box should contain a verbose template before you even get started. Does it instead only contain prompts? Show us what your actual template looks like in addition to the final note.

Again, I'm very sorry. I just had no idea that it was actually a useful feature as it previously existed. We will be more careful in the future to not break existing functionality with an "improvement". We are generally very good about that.

Please comment on which of the above improvements would be enough to make you feel like you had not lost any functionality.

[fishdrzig]

I would suggest a popup box where we could choose a tooth from a chart with just a mouse click (either permanent or primary).
Really all that is needed is just a prompt followed by options that would pop up, could be chosen, and then the next prompt etc... Within the choice also make available the option for another list of choices. For example


Fillings done on tooth/teeth {tooth chart prompt} Anesthesia used was (prompt for choice)
Note would be: Fillings done on tooth/teeth #3(prompt for surfaces)(prompt for restorative material used) and tooth #12 (prompt for surfaces)(prompt for restorative material used) Anesthesia used was articaine 1:100,000 epi (prompt for how much and prompt for where it was given} etc...... So we would have text already entered and at the appropriate spots, the computer would ask us the prompt questions we could then choose an answer for from the list of answers we create on an individual basis. Unlimited amount of choices and prompts should be available.

I am also guessing we could then just make these notes part of the procedure code notes that would automatically get generated, and we can just modify them with the prompts. Just some suggestions.

I really feel this is the only part of the program that is weak. For those of us who have used other Automatic note generators in other practice management systems, this is a must to have this work seemlessly. Hard to back to the old way. Thanks

[savvy]

OK......
I'm getting closer, still can't change on the fly but.......

Here is my template for a direct restoration class II:

Patient presents for restoration of tooth number [Prompt:"Tooth#"] due to[Prompt:"Reason for filling"].
Placed topical anesthetic using [Prompt:"Topical Anesthetic"]. Administered [Prompt:"Quantity"][Prompt:"Anesthetic"].Excavated and removed all caries. Confirmation obtained using Clearfil Caries Finder. Placed Paladent Matrix using wedge and Bitine Ring. Etched cavity prep with [Prompt:"Etchant"]. Placed [Prompt:"Primer"]. Placed [Prompt:"Adhesive"], thinned using air, light cured for 20 seconds.Placed [Prompt:"Filling Material"] and light cured for [Prompt:"Light Cure"] Filled remaining cavity prep with incremental placement of [Prompt:"Filling Material"] and light cured for [Prompt:"Light Cure"]. Checked occlusion. Smoothed, polished and flossed contact. Next visit:[Prompt:"Next Visit"]

Here is the charted treatment notes:

Patient presents for restoration of tooth number 3 due to recurrent caries.
Placed topical anesthetic using Sultan Pina Colada. Administered .90 cc 2% Lidocaine HCL w/ 1:100K epi. Removed existing MODL amalgam and dycal base. Excavated and removed all caries. Confirmation obtained using Clearfil Caries Finder. Placed Paladent Matrix using wedges and Bitine Rings. Etched cavity prep with 37% Phosphoric Acid for 20 seconds; rinsed w/water 5 seconds; air dried 2 seconds,. Placed SA Primer for 20 seconds; air dried 2 seconds. Placed Clearfil Photobond, thinned using air, light cured for 20 seconds.Placed Tetric EvoFlow and light cured for 20 seconds Filled remaining cavity prep with incremental placement of Tetric EvoFlow and light cured for 20 seconds. Checked occlusion. Smoothed, polished and flossed contact.N/A: fillings

One still has to answer all the prompts as skipping is verbotten.
On the fly changes are not possible, but simple changes after the fact are easily possible. I had to had the part about amalgam removal after.

There is hope.

[jordansparks]

Yes. That verbose version of your template is exactly what I envisioned. That seems more readable and more powerful than the old way of doing autonotes. It is my plan to quickly fix the deficiencies, especially skipping and altering on the fly.

[atd]

Please comment on which of the above improvements would be enough to make you feel like you had not lost any functionality.

Since I haven't upgraded to the new version yet it's hard to comment in a meaningful way on what to change. But #2, 3 and 6 sound really good. In the old Auto Notes I always wished I could access the quick paste notes within the text box fields.

Looking forward to trying them out!

[savvy]

I am now offering an unclinched fist......

Cheers!!!

[savvy]

If you haven't yet updated, may I suggest that you create a Word document that is a series of all your most used,or for the ambitious, all of your current Auto Notes variables (Cut/paste).

If you have already updated, create a Word doc with examples of your most common procedure notes that you created using Auto notes.

This new Word doc, which is just a list of various treatment paragraphs will be much easier to refer to, compared to bouncing back and forth through OD.

Open up Auto Notes in Setup, choose a note from the initial Auto Notes window, (for example: Prophylaxis). Paste the corrosponding completed treatment note from the Word doc in the large Text Box. As you read through the note, every time you get to a segment where you want variables, if it isn't already created in the Available Prompts list, creat the prompt, Then add the various variables you want. Enter that new prompt in the appropriate position of the copied treatment note. Delete the portion of the treatment note that had the variable you chose when you created the note originally.

Example of pasted treatment note:

ORAL HYGIENE EVALUATION: Excellent oral hygiene home care. Light Interproximal Plaque with mild to moderate plaque on the linguals of the lower anteriors.

ORAL HYGIENE INSTRUCTIONS: Flossing suggested to the patient especially in the molar areas.

TISSUE EVALUATION: Excellent tissue health. Interdental papillae show knife edge condition with nice stippling of oral tissue.

PROBING DEPTH EVALUATION: Patient shows general pocket depth of not less than 3mm and not greater than 5mm.

TODAY'S TREATMENT: Adult prophylaxis and oral exam. Patient placed on 6 month oral hygiene recall.

TYPE I: GINGIVITIS

Pat Jeong, RDH

Example of finished template note for "Prophylaxis":

ORAL HYGIENE EVALUATION: [[Prompt:"Grade"] oral hygiene home care. [Prompt:"Amount of Plaque/Calculus"] Interproximal Plaque with [Prompt:"Amount of Plaque/Calculus"] on the [Prompt:"Plaque Surface"] of [Prompt:"Quadrant"] [Prompt:"Quadrant"].

ORAL HYGIENE INSTRUCTIONS: Flossing suggested to the patient especially in the [Prompt:"Quadrant"] areas.

TISSUE EVALUATION: [Prompt:"Grade"] tissue health. Interdental papillae show [Prompt:"Papilla"] condition with [Prompt:"Gingival Tissue"] of oral tissue.

PROBING DEPTH EVALUATION: Patient shows general pocket depth of [Prompt:"Pocket Depth"].

TODAY'S TREATMENT: [Prompt:"Prophy"] and [Prompt:"Exam"]. Patient placed on [Prompt:"Recall Schedule"] oral hygiene recall.

[Prompt:"Perio Diagnosis"]

[Prompt:"Provider"]

So there you have it......it's doable.

NOTE TO JORDAN:
It would be much better and easier to fill out a template that has many variables, like the above example, if one could be able to read the note at the same time one is selecting a variable from a prompt. As it is, it gets very confusing trying to remember where one is during the progress of creating the note since the prompts just appear one right after the other.

Cheers!!!!

[jordansparks]

The following enhancements have just been made to the autonotes:
1. Automatically convert the commas to carriage returns (saves time in setup if you already have extensive autonotes entered).
2. Allow skipping prompts that do not apply.
3. Allow freeform text in addition to the pick list while still in the prompt.
4. MultiResponse type.
5. Highlight the current prompt in the text in yellow as the entry is being made.

The enhancements will be posted shortly.

[fishdrzig]

I was working on the AutoNotes in the version prior to 6.4.8 and seemed to work but I just updated am now am on v 6.4.8 and it seems like the highligthing and prompt boxes do not work anymore? Just an FYI

[jordansparks]

I just downloaded and installed 6.4.8, and the autonotes work great.

[cneelley]

I'm using version 6.4.8 and it seems to be working just fine for me.

Dr. Neelley