However, you should be aware that antivirus software slows the performance of your computer in general, including the performance of applications such as Welford Chart Notes. The amount of slowing can vary from product to product, especially depending upon how it is configured.

For example, if you use Norton Antivirus, if you select the Options button, under Which file types to scan for viruses, the factory default setting is Comprehensive file scanning (recommended). This causes Norton Antivirus to check for a virus every time you open and read any file on your computer. Although this provides the greatest possible protection against viruses, it markedly slows down an application like Welford Chart Notes, which must open and read many files often hundreds of times in the course of opening a patient's chart (looking up the allergies, medications, lab results, diagnoses, etc.). The vast majority of these data files used by Welford Chart Notes have names ending in .FIL. If you instead select Scan files using Smart Scan, Norton Antivirus will not scan files with names ending in .FIL (unless you further press the Customize button and then add .FIL to the list of What files to scan. Using Smart Scan is only slightly less safe than using Comprehensive file scanning, and markedly increases performance of Welford Chart Notes, especially the 32-bit version. (The SQL version uses some .FIL files, but the vast majority of the data are in SQL tables, not in .FIL files).

@LastAssessment (which is the same as @LastAssess) copies the assessment portion of the patient's preceding non-Telephone note into the Advanced Writer at the current cursor position, and places a non-printing marker after the colon on each line, or at the end of any line which lacks a colon. You can then use the <F9> key to jump to each non-printing marker to write your assessment for today's visit, should it differ from the last visit. @LastAssessment copies the entire assessment, including problem labels and the discussion which follows each one.

@LastAssessment: (which is the same as @LastAssess:) (notice the colon at the end of these @functions) copies just the problem titles from the assessment portion of the patient's preceding note. The problem titles are the portions just before each colon, and the colons. (below, * represents a non-printing marker).

To see the difference between @LastAssessment and @LastAssessment:, suppose the previous note reads:

Assessment:

1. Chest pain: this is probably angina.

2. Hypertension: well controlled.

Plan:
1. Treadmill test. {etc.}

@LastAssessment is replaced with:

1. Chest pain: *this is probably angina.

2. Hypertension: *well controlled.

@LastAssessment: is replaced with:

1. Chest pain: *

2. Hypertension: *

If you tend to keep the same assessment discussion for most of your problems from visit to visit, you will prefer to use @LastAssessment, and just change the discussion text for those problems whose assessments have changed. On the other hand, if you tend to have new assessment discussions for each problem each visit, use @LastAssessment: instead. Remember to place a colon after each problem's name the first time you write a note for a patient.

The program defines the beginning of the assessment portion of the previous note as the text immediately following any of the following labels: A:, ASSESSMENT:, or ASSESS: (regardless of capitalization; Assessment: also works). The label must be at the beginning of the line, not counting any spaces or tab characters.

The program defines the end of the assessment portion of the previous note as whichever one of the following appears first:

1. Two non-printing markers in a row (created by pressing <F8><F8>);

2. Any of the following labels: P:, PLAN:, PLANS:, RECOMMENDATION:, or RECOMMENDATIONS:; or

3. The end of the note.

You will therefore probably want to use an assessment and a plan label routinely in your notes, and in fact embed them into your Templates (e.g. a simple S: O: A: P: template can serve as a skeleton for any note) so that @LastAssessment will work for you every time you write a note.

@LastPlan works just like @LastAssessment, except that it copies over the text starting at one of the plan words (P:, PLAN:, PLANS:, RECOMMENDATION: or RECOMMENDATIONS:) and ending at the end of the note.

Again, if your plans tend to be the same for most problems from visit to visit, use @LastPlan. If they usually change, use @LastPlan: instead.

Here is another example: suppose your last visit reads:

PLAN:

1. Chest pain: stress test.

2. Hypertension: continue atenolol 50 mg po qd.

@LastPlan is replaced with:

1. Chest pain: *stress test.

2. Hypertension: *continue atenolol 50 mg po qd.

@LastPlan: is replaced with:

1. Chest pain: *

2. Hypertension: *

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Rockford, IL 61114

or

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Hoffman Estates, IL 60195

http://medcom@emirj.com