Medinotes Conversion –

Load Procedure

Medinotes conversions are available for Versions 9.33 and above. The following procedure was prepared from a
number of converted beta sites, using Medinote in a variety of ways. However, users of any system have a great
talent for finding unique methods for entering and using data, so it is possible the next conversion will be met with
new obstacles.
In any data conversion, some data input into the original system may be incompatible with the requirements of the
target system, and cannot be loaded. For example it may be possible to enter medication refills as free text in the
original system, while the target system only allows for numeric entry. Or free text date entry may be allowed in the
original system, but not the target system. In these cases, a reconciliation report is available for interpretation and
direct entry of data that does not load.

Once data has been converted, please have the clinic review it and sign the completion form, indicating go live, so
that support can provide assistance if necessary. By agreeing on completion of converted data or by entering new
data as live, any changes to the loaded data can only be accomplished manually.

Before you ship the hard drive to Ellkay

Before you ship the Medinotes data hard drive to Ellkay, take note of the Medisoft Provider IDs, shorten them to three
characters if necessary and provide them on the form included with the hard drive shipped to Ellkay.

While Ellkay is converting Medinotes

Install Medisoft Clinical, add the three character provider IDs, cross reference connector if necessary, sync with
Medisoft, and begin training and possibly using Medisoft, using Medinotes as reference only.
When Ellkay receives the hard drive with Medinotes data, they will provide you with a list of immunizations names to
be translated into the following default choices. Use these when possible, and indicate a new name if necessary.
Names must be 18 or less characters and the clinic must make the translation decisions. Return the desired
translations to Ellkay.

DTAP MMR
HEPATITIS A PNEUMOCOCCAL CONJ.
HEPATITIS B PNEUMOCOCCAL POLY.
HIB TD
INFLUENZA VACCINE TDAP
IPV VARIELLA
MENINGOCOCCAL

If this conversion package includes OB History, Ellkay will provide you with a list of names to be translated. The list is
too long to include here. Open Medisoft Clinical, select Maintenance, Templates, Lab Data Test Names. Use a
corresponding default when possible, and add a new name if necessary. Names must be UPPER CASE and 18 or
less characters and the clinic must make the translation decisions. Return the desired translations to Ellkay.

When the hard drive is returned - Overview

The following steps will complete the conversion. Load times are shortest when performed directly on the server and
CTREE Server disabled. If staff must work in the EMR during the load, do not disable CTREE Server.
Install an EMR client on the server where you will do the load
Sync Medisoft with Medisoft Clinical – if you haven’t already
Before the load
Copy the loadfiles from Ellkay
Install xFire and load demographics (~1.5 hours)
Load clinical data (8hr/5k patients)
Reconcile the load (~3 hours)
Reverse Configuration changes

1 Revised August 12, 2010

Before the load
If you will be loading Immunizations, Ellkay will have provided a list of Health Maintenance names that must be
present in the EMR, before you do the load. From the EMR, select Maintenance > Templates > Health Maintenance
Names. Check the list for an exact match (case and space) with the name on the Ellkay translated list. If an exact
match does not exist, please add it, otherwise the Immunization data will not load.

Required Configuration changes to Medisoft Clinical:

1. Maintenance > Configuration > Customize Patient Chart for Site

Select Undefined #A (if not available use next open category)
Rename Category: MNDOCLinks (case sensitive)
Press OK

Select Undefined #J (if not available use next open category)

Rename Category: MNLoad (case sensitive)
Press OK

2. Maintenance > Special Features >

Records 2 > Create Other Problems from Note Titles > Uncheck
Records 2 > Show Dot Codes and Label Markers….. > Uncheck
Records 2 >Use Native application for PLINK > Check

3. Edit PPART.INI
Find [PracticePartner]
Add VSCERange=OFF

Copy Files
1. Create a subdirectory P:\ppart\LoadMN
2. Copy the loadfiles from the Ellkay hard drive to P:\ppart\LoadMN
Master: Format and content files for Demographic, Carrier, Provider and Laboratory
Clinical: The clinical data
Images: Images for all Patients
PatientPictures: Patient Photos for manually linking
Summary: Summary reports for the conversion.
3. Copy the corresponding Version DLL P:\ppart\LoadMN\Master\9xxDLL\*.dll to P:\PPart
(may need to stop services first)
4. Copy P:\ppart\LoadMN\Clinical\LoadMN.bat to P:\PPart
5. If you are loading images, create applicable subdirectories
P:\PPart\MNImages\Images Images Stored in Database
P:\PPart\MNImages\Docserver Images Stored on Doc Server
P:\PPart\MNImages\EScan Images Stored in MediNotes EScan
6. P:\ppart\LoadMN\Master\Summary\Summary.pdf includes the current location of each of the images
types. Copy the image files to applicable subdirectories.
7. P:\ppart\LoadMN\Master\Summary\Summary.pdf also includes a summary of the number of patients
extracted by Ellkay.

Install XFire for Demographics and Maintenance loads (Reference Article 134068 for instructions)
The XFire version must match the current EMR version.
Run installation twice, once for the Demographics and another for Maintenance Loads
1. Demographic Interface will be stored in P:\PPart\Interface\XFire
2. Maintenance Interface will be located in P:\PPart\Interface\XFireMAINT

Loading Providers, Insurance Carriers and Laboratory Data

For the fastest possible load, if using CTREE Server, ensure no one else is in the EMR, and disable CTREE Server.
Edit XFireMAINT.ini and change the quote delimiter from Quote=35 to Quote=34 (search/replace)
• If the EMR is currently on 9.4 you will not need to change the quote delimiter

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Run XFire.exe from XFireMAINT directory; select File, Configuration and BROWSE to select:

File, Configuration: P:\ppart\Interface\XFireMAINT\XFire.ini

Format File: P:\ppart\LoadMN\Master\Provider_MN.xml
Input File: P:\ppart\LoadMN\Master\Provider.imp
Select OK, then Start. Will complete on average 5 seconds.

File, Configuration: P:\ppart\Interface\XFireMAINT\XFire.ini

Format File: P:\ppart\LoadMN\Master\Carrier_MN.xml
Input File: P:\ppart\LoadMN\Master\Carrier.imp
Select OK, then Start. Will complete on average 10 minutes.

File, Configuration: P:\ppart\LoadMN\Master\\XFireLab.ini

Format File: P:\ppart\LoadMN\Master\Lab_MN.xml
Input File: P:\ppart\LoadMN\Master\Laboratory.txt
Select OK, then Start. Will complete on average 4 minutes.

For example:

Loading demographics
For the fastest possible load, if using CTREE Server, ensure no one else is in the EMR, and disable CTREE Server.
Run XFire.exe from XFire directory, select File, Configuration and BROWSE to select:
Configuration File: P:\ppart\Interface\XFire\XFire.ini
Format File: P:\ppart\LoadMN\Master\Demographics_MN.xml
Input File: P:\ppart\LoadMN\Master\Demgraphic.imp
Select OK, then Start. 5,000 patients will complete in 20 minutes on average.

If any demographics were “Unsuccessful”, use Wordpad to edit P:\PPart\Interface\XFire\Log\Event;search for “Fail”
to identify which patients may need to be manually added, if excessive contact support.
When complete, verify with Task Manager, that the process XFire is not running, and if it is, end it.
Make a backup copy of P:\ppart at this time.

3 Revised August 12, 2010

Loading Clinical Data
Ellkay has provided a batch file named LoadMN.bat that will load each patient’s clinical data. There may be
two files per patient (where ### is the patient ID)
###_ Note.dat for Notes
###_C.dat for all other data

Run the batch from P:\ppart\LoadMN.bat, preferably from a DOS prompt for more visual control.

The batch has syntax of: Textload P:\ppart\LoadMN\Clinical\PatientID\Filename n n y

If it becomes necessary to edit any file, back it up, and use notepad to search and replace. Data is loaded
based on Patient ID ONLY. Load times will vary depending on the amount of data to load and the speed of
the server used.

At the end of the load a reconciliation report will be generated, which is produced from the CKMNLD1.exe

Reconciling the Data Load

The report P:\ppart\LoadMN\CKMNLOAD.txt will indicate data that was not loaded and may be entered manually
into the EMR.

Reverse Configuration changes

After the load, reconciliation and post loads:

1. Maintenance > Special Features > Records 2 > Create Other Problems from Note Titles > Check

2. Edit PPART.INI
Find [PracticePartner]
Remove the line VSCERange=OFF

3. Run the utility SGNNOTES to sign off all progress notes.

a. Create a Provider ID of ADM with signing privileges in practice partner
b. ppart>SGNNOTES <begindate> <enddate> <password> <*ALL*>
mm/dd/yy

4. If there were Medinote patient photos, they were extracted to P:\ppart\LoadMN\PatientPictures

For easy access when creating new links in the new EMR.

Sign Off
Once data has been loaded, please have the clinic review the data depending on the conversion package and sign
below to indicate go live, so that support can provide assistance if necessary. By agreeing on completion of
converted data or by entering new data as live, any changes to the loaded data can only be accomplished manually.
Depending on the conversion package:

Patient Demographic Surgical History Immunization History

Insurance Carrier Table Social History Lab Results
Past Medical History Family History OB History
Medication History Diagnosis Allergies
Patient Notes Vitals Scanned Images

_____________________________________ _____________________________________
Clinic Physician (sign) Clinic Physician (print)

_____________________________________ _____________________________________
Clinic Name (print) Date

4 Revised August 12, 2010

Possible errors:

The following message will occur without following “Copy files #3”

Environment interruptions in load:

Take note of the last file (0000008842_C.dat in this case), edit LoadMN.bat, find the file, and delete all above it, so
that when you start the batch again, you begin to load the same file.

5 Revised August 12, 2010

Means the file you are trying to load is too large.
CHMBLOAD.TXT report errors
Reason
An .RX: line must precede a .SIG: line
Could Not Find a Note Within the File...
.D: Line Format Error
.D: Line Must Directly Precede .K: Line
.D: Line Must Directly Precede .T: Line
Duplicate Problem (2)
Duplicate Text - not loaded (1)
End of Messages for an embedded note
Health Maintenance Locked, Data Not
Description
All .SIG: lines must be preceded by a .RX: (or .RX2:, etc.) line so
that the Text Data Loader knows which medication the extended sig
belongs to.
This error applies to RTF files loaded through the Text Data Loader.
The date on the .D: line is invalid, or the .D line is missing. Correct
the date and reload it.
The .D: line has been entered incorrectly. Correct the line and
reload the note.
The text was not loaded. Applies to all categories of data except
progress notes. Correct and reload.
The text was not loaded. Applies to progress notes only. Correct
and reload.
There is another progress note for this patient and date with
identical secondary (that is 2nd, 3rd, 4th or 5th) problems for the
same date and time. The note will not be indexed by the duplicate
problem and will not be retrievable by that problem.
A progress note for this patient with the same date, time and
primary problem (that is, the first problem on the .T: line) has
already been loaded. This note is regarded as a duplicate. To load
two progress notes with the same date and time, change the title for
the second note. For example, if two X-Ray reports were recorded
on the same day, give them different titles.
The preceding error messages applied to embedded text (e.g., Past
Medical History, EKG, etc.) and the subsequent error messages
apply to the starting note for the patient (e.g., the progress note).
Another user was editing health maintenance procedures for this
6 Revised August 12, 2010
Loaded
Illegal Single .K: Line
Insufficient memory: .RX: lines not loaded
Insufficient memory: .SIG: lines not loaded
Invalid Date Format
Invalid Diagnosis format: not loaded
Invalid note category -- the .K: is not a valid
text category and the entry has been included
as text
Invalid Procedure format: not loaded
Invalid time format -- time on .D: is not valid
Invalid time format or patient not registered --
time or patient ID on .D: is not valid
.K: Line Format Error
Medications Locked, Data Not Loaded
No Template in Age Range: Health
Maintenance Not Loaded
Note is too long--so it was only partially
loaded
Note with this date and title already exists.
Partial note was not loaded because note
with the same date and marker does not exist
for this patient
patient or the file was locked. Enter health maintenance information
directly in the health maintenance section of the patient chart.
The .K: has been ignored and the entry has been included as text.
There was insufficient memory available to load the .RX: lines. You
may need to reconfigure your computer so that more memory is
available.
There was insufficient memory to load the .SIG: lines. You may
need to reconfigure your computer so that more memory is
available.
The date on the .D: line is invalid. Correct the date and reload it.
The diagnosis code format was incorrect. Fix the diagnosis directly
in the patient chart.
This error message applies only to HTML notes. When using the
Text Data Loader, .K: lines must be worded exactly the same as the
patient chart tabs. For example, you must enter ".K: Family History,"
not ".K: History of Family." If you do not include a .K: line, the Text
Data Loader assumes that you are loading a progress note, and the
text on the .K: line is added as note text.
The procedure format was incorrect. Fix the procedure directly in
the patient chart.
This error message applies only to HTML notes. HTML notes
require a time after the date. Make sure the note uses this format:
.D: date : time : patient name : patient ID
For example:
.D: 01/01/04 : 10:00 am : Stein, Richard : 100-10
This error message applies only to HTML notes. HTML notes
require a valid patient ID and a time after the date. Make sure the
note uses this format:
.D: date : time : patient name : patient ID
For example:
.D: 01/01/04 : 10:00 am : Stein, Richard : 100-10
The .K: line is incorrect. Correct the line and reload the note.
Another user was editing medications for this patient or the file was
locked. Enter medications directly in the medications section of the
patient chart.
There is no individual template for the patient and no template for
the patient’s sex and age group. As a result, Health Maintenance
could not be loaded. Enter health maintenance data directly in the
health maintenance section of the patient chart.
The note is too long for the Text Data Loader. The maximum note
length for “old style” notes is 999 lines. There are no limits for HTML
style notes.
This error message applies only to HTML notes. To load correctly,
HTML notes must have unique dates and titles. Change the date
and/or title of the note.
This error message occurs when you attempt to replace partial note
markers in an existing note with text from the imported text data file,
but Patient Records either could not find a note matching the
information in the .D line of the uploaded file or could not find the
partial note markers identified by .P lines in the uploaded file.
Ensure that the .D line correctly identifies the date, time, patient
name, and patient ID of the existing note:
.D: 01/01/04 : 10:00 am : Stein, Richard : 100-10
Ensure that any .P lines correctly identify the partial note markers
you want to replace in the existing note:
.P: 1001
7 Revised August 12, 2010
Patient ID Different From Name
Patient Not Registered
Problem List Locked, Data Not Loaded
Problem List Not Loaded
Progress Note Locked, Data Not Loaded
Read Error
Some Allergies Not Loaded
Some Health Maintenance Not Loaded
Some Medications Not Loaded
Some Vitals Not Loaded
.T: Line Format Error
The .PV: line must be within the first few lines
of the note
The Rx duration value is invalid
The note could not be loaded because the patient ID did not
correspond to the patient name. Make sure that the patient name is
spelled correctly and that the identification number is right. Correct
the name or number and reload the note.
There is no patient registered with this identification number. Make
sure the patient is registered. Then reload the data.
Another user was editing the problem list for this patient or the file
was locked. Enter the problems from the .T: line directly into the
problem list section of the patient chart.
Some or all of the problems on the .T: line could not be loaded. Add
these problems directly in the problem list for the patient.
Another user was adding or editing information for the patient
whose information was being loaded or the file was locked. Reload
the progress note.
A potentially serious read error occurred during the load. Run the
CHECK utility to make sure all the files are intact. Then reload. If
you see primary duplicate errors, they can be ignored. Make sure
that all data for this patient has been successfully loaded, by looking
at it in Patient Records.
Some or all allergies could not been loaded. Add these allergies
directly in the medications section of the patient chart.
Some or all health maintenance procedures could not be loaded.
Add these health maintenance procedures directly in the health
maintenance section of the patient chart.
Some or all medications could not be loaded. Add medications
directly in the medications section of the patient chart.
Some or all vital signs could not be loaded. Add the vital signs
directly in the vital signs section of the patient chart.
The format of the .T: line is incorrect. Correct the line and reload the
note.
The .PV: line must be in the first ten lines of the note.
Valid entries for Rx duration are blanks, prn, -, or a number less
than 1000.

The Rx Medication Name is missing or is too The maximum length of an Rx medication name is twenty-five
long characters.
The Rx refills value is invalid Valid entries for Rx refills are blanks, or a number less than 1000.
Too Many .H lines The maximum number of .H: lines per note is 10.
Too Many .L: lines The maximum number of .L: lines per note is 160.
Too Many .MP: lines The maximum number of .MP: lines per note is 200.
Too Many .OP: lines The maximum number of .DX:, .OP:, and .PR: lines per note is 200
lines combined.
Too Many .RX: lines The maximum number of .RX: lines per note is fifteen.
Too Many .SIG: lines The maximum number of .SIG: lines per note is ten.
Too Many .T: lines You may only enter a single .T: line for each note.
Too Many .TME lines You may only enter a single .TME: line for each note.
Too Many .V: lines You have attempted to enter too many .V: lines for the note.
Unknown .K: Line The format of the .K: line is incorrect. Make sure your entry is
spelled correctly and reload it.
Vital Signs Locked, Data Not Loaded Another user was editing vital signs information for this patient or
the file was locked. Enter the vital signs information directly in the
vital signs section of the patient chart.
Write Error A potentially serious write error occurred during the load. Run the
8 Revised August 12, 2010
CHECK utility to make sure all the files are intact. If so, reload them.
If the files are damaged, you may need to use the BUILD or FIX
utilities to recover them. After you see a write error and you reload
your data, you may see primary duplicate errors. These can be
ignored. Make sure that all the data for this patient has been
loaded.

9 Revised August 12, 2010