# Paper or Computer?



## lightsandsirens5 (Apr 27, 2009)

Well, I'm sure it has been discussed before on here, but to let all the new people in on it and to allow for changes that have taken place since then, I'll ask.

How do you do your reports? Paper based or computer based? How are they submitted? Online, by mail, by hand, some other way?

The poll is just covering report types, paper or computer.

At my service, we are currently still doing paper reports but we are just starting to switch over to the Image-Trend Field Bridge program.


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## Sapphyre (Apr 27, 2009)

Paper submitted by hand.


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## Ridryder911 (Apr 27, 2009)

Almost all EMS agencies will be going to paperless within a few years or will have someone enter the required NEMSIS information. Most have adopted to the National EMS Information System or face the consequence of loosing Federal funding. 

Our state has mandated that NEMSIS information and as well State information be placed into either per PCR or paper type system that will have to be entered manually by someone into the e-pcr. 

R/r 911


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## JPINFV (Apr 27, 2009)

Ambulance: Paper 
Waterpark: Paper report that got retyped into Word with both being submitted.


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## Mountain Res-Q (Apr 27, 2009)

I've used both depending on where I am working.  I started with paper PCRs and then used computer, and then back to paper... and true be told, I prefer paper... so that is how I voted since I use both.


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## trevor1189 (Apr 27, 2009)

Both stations I am with use EMStat. I haven't personally used it, because I'm not an EMT yet. I have heard people complain about it, but I don't know if that is just the "paperwork" aspect of the job or the actual program. I have seen it being used and I can say it does seem very thorough if nothing else.


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## Vicious (Apr 27, 2009)

I'm such a techno junkie that I definitely would rather submit things by computer. Anyways going "green" by not using paper as much helps the environment too.


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## Hockey (Apr 27, 2009)

The one county I work full time in is now all computer.  Each company has a different program.  There is about 3 different programs.  

The one we use the fields are SOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO TINY ITS NOT EVEN FUNNY.  YOU HAVE TO SQUINT TO REALLY SEE


The other agency I work with uses the more common computer report.  Not bad.

Sometimes I do wish I could use the paper format though


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## mikeN (Apr 28, 2009)

my company has been using computers for 3 or 4 years now.  We use zoll rescue net or something like that.  It's super easy to use after a week or two. We submit our reports as soon as we close out the call.Sending the call to dispatch immediatly after you are done with your PCR has saved my *** majorly once. With the computer the run report is faxed to the EDs as soon as it is sent to dispatch and the company like it because they can bill the call immediatly.  The only paper I've ever written on in BLS is my notepad.


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## lightsandsirens5 (Apr 28, 2009)

Wow. I never would have guessed that more people use paper than computer. I guess it is not a far along as some would have you beleive.


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## Ridryder911 (Apr 28, 2009)

lightsandsirens5 said:


> Wow. I never would have guessed that more people use paper than computer. I guess it is not a far along as some would have you beleive.



Yeah, it will be amazing upon how services will be changing so fast and not preparing their employees for changes and all the frantics that will be following... again; typical EMS . 

R/r 911


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## DrankTheKoolaid (Apr 28, 2009)

*re*

Out here in the sticks weve been using computer generated PCR's since 1998 and we sure do miss the original program.  The garbage programs Norcal EMS keeps pushing sucks arse.  Tons of errors and much to my dismay there is a character limit in the narrative portion. Most dont find a problem with it, but i hate using check boxes and would rather do my ROS in the narrative.

  Oh and there delivered by hand since the frickin lawyers behind HIPPA have everybody so paranoid the refuse to recieve them any other way.


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## Shishkabob (Apr 28, 2009)

AMR here is using paper.


Yay paper..........:glare:


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## Hazmat91180 (Apr 28, 2009)

Ridryder911 said:


> Yeah, it will be amazing upon how services will be changing so fast and not preparing their employees for changes and all the frantics that will be following... again; typical EMS .
> 
> R/r 911



I am going through this RIGHT NOW. We went to tablet PCs on the rigs and are using firehouse mobile ePCR, and the speed in which it was rolled out didn't work at all for our department and now we are back to paper, and guess who is heading up the Tablet Committee to get these back on our rigs working properly?

I would love to here any insights on anyone using Firehouse with the Integration of Firehouse Mobile ePCR. Feel free to PM me as well, I would like to pick some people's brains on the implementation.


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## Sasha (Apr 28, 2009)

Linuss said:


> AMR here is using paper.
> 
> 
> Yay paper..........:glare:



Don't you love the hand cramps!?


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## Outbac1 (Apr 28, 2009)

We started using computers about two years ago. I think the program is Medusa. We have Toughbook laptops in the trucks and an automatic wireless submission as we input our info. We have a printer or two at every hosp ER to print out our reports. It took some getting used to but not bad once you've got the hang of it.


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## Sapphyre (Apr 29, 2009)

lightsandsirens5 said:


> Wow. I never would have guessed that more people use paper than computer. I guess it is not a far along as some would have you beleive.



Apparently, the county I work in is insisting on a particular set up, whose cost is quite high to implement, and the company doesn't want to use that set up, so, supposedly, they're holding out for the county to pay for it, since they're being so picky.  Or, something like that.  But, yes, I can see quite a few of my coworkers going batty trying to learn how to use the system when we finally get it.  For now, we're still on paper.


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## vquintessence (Apr 29, 2009)

Sapphyre said:


> Apparently, the county I work in is insisting on a particular set up, whose cost is quite high to implement, and the company doesn't want to use that set up, so, supposedly, they're holding out for the county to pay for it, since they're being so picky.  Or, something like that.  But, yes, *I can see quite a few of my coworkers going batty trying to learn how to use the system when we finally get it*.  For now, we're still on paper.



I'm sure there is a commonality within that group of employees?  *ESP*!

*E*xperienced (more specific to years served than knowledge) *S*treet *P*roviders.


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## mar7967 (Jun 30, 2010)

I was going to start a new thread on this, but found this one instead. Has anything changed for you?

I work at two different agencies. Both use Electronics Patient Care Reports as required by either NY State or the region we are in. Both places us EMScharts which I like a lot (although I have never used anything else so I can't compare). Both places have laptops on the ambulances to enable us to work on charts while in the ambulance with the patient (for stable patients) or on the way back from the hospital. Does anyone else use this?


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## Sassafras (Jun 30, 2010)

We have toughbooks with my volunteer unit, but desk tops with the paid unit.  Both companies use the same program format, but the thing I've noticed is IT has to manually input most things like signs and symptoms.  We get pain but not childbirth.  Apparently people don't give  birth up here LOL.  Slowly we are finding what's missing from the program and informing IT to add it, but really, I sometimes wonder why they don't automatically include all of the information before it's released for purchase.


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## mcdonl (Jun 30, 2010)

We use Imagetrend in Maine. Maybe because I am a rookie, or maybe because of a "lifetime" in Healthcare IT, I prefer to NOT use a tough book in the back of the ambulance. I like to write down my findings, and document them in the EMS room at the hospitals we transport too. Sometimes I will record vitals on the laptop if I am the third hand, but if I am primary or assisting an ALS provider I prefer pen and paper.

Also, because if a background in IT, specifically healthcare IT I find it pretty easy to do the electronic run report at the PC where my skills at an EMT are still growing so I like to focus on the patient and what I am finding more so than the software.


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## mar7967 (Jun 30, 2010)

mcdonl said:


> We use Imagetrend in Maine. Maybe because I am a rookie, or maybe because of a "lifetime" in Healthcare IT, I prefer to NOT use a tough book in the back of the ambulance. I like to write down my findings, and document them in the EMS room at the hospitals we transport too. Sometimes I will record vitals on the laptop if I am the third hand, but if I am primary or assisting an ALS provider I prefer pen and paper.
> 
> Also, because if a background in IT, specifically healthcare IT I find it pretty easy to do the electronic run report at the PC where my skills at an EMT are still growing so I like to focus on the patient and what I am finding more so than the software.



I tend to agree. Because we can pull up patient history in out computer though, I like to check if our patient is in the system. If they are, I confirm everything in there with them. If not, I usually drop the computer and write it all down. I think its more 'personal' if you write it rather than type right into the computer.


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## thegreypilgrim (Jun 30, 2010)

We're still using old fashioned pen and paper here. Typical LA county, stuck in the damn Bronze Age and fighting any and all attempts at transitioning to the modern world to the death. What do they say in the fire service? "You can't change 200 years of tradition"? I think that statement originated here. I seriously think people here would be happy with quilled pens, ink wells, and papyrus or using hieroglyphics to write PCRs.


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## adamjh3 (Jun 30, 2010)

Paper here. I'm with an IFT company in San Diego. We have to fill out practically the same damned sheet three times. Company PCR, county PCR, and then the Scantron on the back of the county PCR. 

I don't understand why we have the company forms, we get to keep a copy of the county form, so why can't they just use that? There is no information on the company form that isn't on the county form.


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## NomadicMedic (Jun 30, 2010)

At one service, we are using Zoll tablet EPCR and it's a huge PITA. I am NOT a fan. Our toughbooks are always losing connectivity, battery life sucks, the dispatch info isn't updated and loaded to the PCR as it should be which prevents it from being completed, the software is clunky and not logical to navigate. Maybe I will get used to it, but it ben a few months and every day i find a new bug or issue. I've used a couple of other electronic EMS charting software packages and I haven't see anything great. Of course, YMMV. (I actually developed a web based EPCR for my paramedic class to submit our reports to the clinical director. It was bare bones, but very easy to navigate and was fast.) 

My other service still uses paper PCRs and while I hate the hand cramps, I appreciate being able to see my PCR as a whole document, write a complete narrative eithout a myriad of drop down menus and then instantly hand a copy to the ED staff at the end of a call.


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## jjesusfreak01 (Jul 1, 2010)

The computer system in Wake County NC is pretty cool. Each rig has one toughbook in the front (navigation and dispatch), one in the back (PCRs). I know there is a wireless router in each truck, so I believe the systems run on that connection (I would imagine cell network?). You can upload data from the monitor into the software, start working on the PCR in the back of the truck (obviously stable patients only), and when you get to the hospital workroom, you can download some of the timing info off the network (dispatch time, time on scene, time off scene, arrival at hospital), and then upload and print the finished reports in the workrooms. Apparently they used to be able to access patient info on the computers until one of them was stolen, now everything has to be reinput every time (sure they'll fix this in the future).

For the record, no medic i've watched has pulled out the toughbook during patient care. They have little runsheet pads they can write notes on, which they will transfer to the laptop when they get the chance. Seems like a good system, but it might take a little too long to write the PCRs than necessary.


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## Dominion (Jul 1, 2010)

We use paper because we don't have the budget for computers.  Additionally our country grant writer is more concerned about getting fire, road department, police, etc grants than EMS.  To my knowledge I don't think we've ever had a grant proposal written for us but we wrote a proposal to upgrade our perfectly fine tornado sirens to a new system that is remotely activated and has all kinds of bells and whistles that links into our dispatch.


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## EmtTravis (Jul 2, 2010)

I work for 2 different companies.. One uses the computer and the other paper.


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## TraprMike (Jul 2, 2010)

*Paper all the way !*

we had Image trend for a bout 3 years,,, nobody liked it.. I think the main issue was the computers we used. very old, slow, ...
about 3 months ago we went to paper forms,, and we all think it's great. only 3 pages, verses tabs across the top, then pull up menues at the bottom.. ARRGGGG..

paper for us now, 5 min and we are done.


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## MrBrown (Jul 2, 2010)

We currently use paper based patient report forms but a new national project is underway to scope out electronic PRFs.  This is a many year, multi million dollar program to design, test and implement a system for hundreds of vehicles and nearly 3,000 Ambulance Officers.

So don't expect results any time soon.


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## Fox800 (Jul 2, 2010)

n7lxi said:


> At one service, we are using Zoll tablet EPCR and it's a huge PITA. I am NOT a fan. Our toughbooks are always losing connectivity, battery life sucks, the dispatch info isn't updated and loaded to the PCR as it should be which prevents it from being completed, the software is clunky and not logical to navigate. Maybe I will get used to it, but it ben a few months and every day i find a new bug or issue. I've used a couple of other electronic EMS charting software packages and I haven't see anything great. Of course, YMMV. (I actually developed a web based EPCR for my paramedic class to submit our reports to the clinical director. It was bare bones, but very easy to navigate and was fast.)
> 
> My other service still uses paper PCRs and while I hate the hand cramps, I appreciate being able to see my PCR as a whole document, write a complete narrative eithout a myriad of drop down menus and then instantly hand a copy to the ED staff at the end of a call.



We use Zoll TabletPCR here, too. I'm not a fan. The system is slooooooooooooow. Bringing up the medications section takes 20-30 seconds after you hit the button. Closing calls and printing reports takes 30-60 seconds. I've used the previous generation of Zoll software before (EMS Pro) and it was MUCH better, and way faster. We sync the addresses and times from CAD, but it won't send over mileage (I haven't figured this one out). Also, syncing with the Lifepak 12 sends over everything EXCEPT respiratory rates, so you still have to manually print vital signs and enter thim. PITA.


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## TraprMike (Aug 25, 2010)

*bump for more poll takers*

I just found this thread, during a search ( yes search works if you know what to search for. LOL). 

this topic was brought up tonight at our meeting..

 we have been computer PCR for about 12 years, and recently went to paper because the comuter's were not working right, and alot of us new people did not like the computer logging software, and neither did our amb director. so we changed until some new software and computer issues are solved. 

looks like on the poll, it's about 50/50.. 

we run about 300 calls / year.


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## KY_EMT (Aug 25, 2010)

Interesting thread....the service I work at uses both. We use paper in the field (for the most part....some of us go ahead and use computer). Then when we get back to the station we'll input into the computer. Then we have to scan the runsheets and all that good stuff. A bit complicated if you're not used to it, and a big waste of time since they pay people to work in the office, but don't let the office workers take care of the rest of the paperwork once the original runsheet is written.


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## 94H (Aug 25, 2010)

Personally I prefer the computer since it cuts down on typos and such

That being said I usually end up doing paper and scanning it in. My service is still working on getting computers into the buses and we can only do computers at a station which we usually only see at the beginning and end of shift, which means staying late. After 12 hours I dont fancy spending any more time in my uniform or at the station


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## DrankTheKoolaid (Aug 25, 2010)

*re*

computer since 1995.  Get with the program you dinosaurs :blink:


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## KY_EMT (Aug 25, 2010)

94H said:


> Personally I prefer the computer since it cuts down on typos and such
> 
> That being said I usually end up doing paper and scanning it in. My service is still working on getting computers into the buses and we can only do computers at a station which we usually only see at the beginning and end of shift, which means staying late. After 12 hours I dont fancy spending any more time in my uniform or at the station



I know how that goes LOL So you essentially have the same system we do. Write the paper, then input into the computer, then scan? LOL Why we even HAVE office workers I'd like to know LOL We EMTs have to do the paperwork.


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## resq330 (Oct 20, 2010)

We have been using Image Trend on Toughbooks since the middle of this year.  Just purchased Service Bridge through them so we can manage more ourselves.  The state has it set up the way they like it.  They don't even require a narrative.


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## emt_irl (Oct 20, 2010)

paper and handed in or mailed to the central office to dossapear into a huge filing cabnit.


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## WVEmt (Oct 20, 2010)

KY_EMT said:


> Interesting thread....the service I work at uses both. We use paper in the field (for the most part....some of us go ahead and use computer). Then when we get back to the station we'll input into the computer. Then we have to scan the runsheets and all that good stuff. A bit complicated if you're not used to it, and a big waste of time since they pay people to work in the office, but don't let the office workers take care of the rest of the paperwork once the original runsheet is written.



Same here. We have run sheets that we write down all the demographics, hx, meds, etc, then we type everything into the computer. After that we scan the run sheet, hospital info, and consent forms, and attach it the the computer copy and submit for qa.


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## the_negro_puppy (Oct 20, 2010)

toughbook


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## looker (Oct 20, 2010)

Ridryder911 said:


> Almost all EMS agencies will be going to paperless within a few years or will have someone enter the required NEMSIS information. Most have adopted to the National EMS Information System or face the consequence of loosing Federal funding.
> 
> Our state has mandated that NEMSIS information and as well State information be placed into either per PCR or paper type system that will have to be entered manually by someone into the e-pcr.
> 
> R/r 911



Can you post regulation that requires this as i haven't seen anything yet. We are currently doing everything by paper and have no intention of switching to computer unless i am forced to.


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## DarkStarr (Oct 21, 2010)

We use AIM, and there's no way I'd ever choose paper over computer.


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## WolfmanHarris (Oct 21, 2010)

Siren ePCR.


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## Simusid (Oct 21, 2010)

We use AmbuPro EMS and I can't imagine living without it.   I guarantee you that my computer reports are more comprehensive than any paper report that I would produce.  AmbuPro leads me through a lot of topics and prompts me for a lot of input that I might forget at 3AM.  

Some say that it bloats the reports and includes unnecessary info (maybe a few too many pertinent negatives) but consider this... The amount of money your service receives from insurance claims is DIRECTLY proportional to the quality of your run reports.  Crappy reporting leads to denials and reductions.  And actually, they don't have to be crappy, just questionable.

And I <3 being able to import all the EKGs, the ETCO2, O2, NIBP, etc all wirelessly right into the report.

So put me down for computer all the way!


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## Seedbird800 (Nov 8, 2010)

*Pen & Computer*

I've seen a product on the Market from EMS Charts that enables the user to complete a PCR on paper using a digital pen that turns the users hand writing into text and automatically populates the fields in the emscharts epcr system.

I saw flight nurses look of shock and delight at seeing their hand writing converted into text on the screen in seconds and then populate the fields in emscharts. The fact that you can write on paper and leave the paper copy behind with the patient at the hospital and you already have the epcr completed on the computer back at base means all you have to do is check it when you arrive back at the base. Rather than spending 90 minutes charting at the end of every shift, you can now do it in minutes.

When I saw the demonstration I really liked the fact that a copy of the original paper chart was created  in a pdf format including signatures.


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## 18G (Nov 8, 2010)

Maryland uses a web based system for PCR completion and in PA EmStat is a widely used program. I like EmStat.


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## EMT11KDL (Nov 8, 2010)

While on the call, I write everything down.  Vital Signs, important information that patient/bystanders tell me, in some weird code that no one else can understand... O wait, thats just my hand writing   after the call I like the computer based reporting system, I transfer my notes to the computer and than  staple all my notes together and put them into the drop box we have for our records keepers to pick up.


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## EMT11KDL (Nov 8, 2010)

18G said:


> Maryland uses a web based system for PCR completion and in PA EmStat is a widely used program. I like EmStat.



We use PERCS...  I actually like this program, its easy to learn and understand.  one down fall about it though, is if the information is not in the drop menu that they supply, you cant add your own choice.


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## TransportJockey (Nov 8, 2010)

We're using Intermedix for our ePCR


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## emtchick171 (Nov 8, 2010)

At our service, we do a handwritten PCR...then once we complete the call we type them on the computer (EMScharts.com) 

However, we do not discard our handwritten reports, they are kept in addition to our computer reports...just a "CYA" thing in case we would need them in a legal case.


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## Seedbird800 (Nov 8, 2010)

emtchick171

From what you have just wrote the SyncPen from emscharts would be idea for you.  You write your notes on paper with the Sync pen. The records what you write. Then the pen updates emscharts.com in seconds. And makes a PDF copy of your hand written notes.  You reduce your keyboard time down to 10 minutes instead of 90.


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## emtchick171 (Nov 8, 2010)

Seedbird800 said:


> emtchick171
> 
> From what you have just wrote the SyncPen from emscharts would be idea for you.  You write your notes on paper with the Sync pen. The records what you write. Then the pen updates emscharts.com in seconds. And makes a PDF copy of your hand written notes.  You reduce your keyboard time down to 10 minutes instead of 90.



WOW! I haven't heard of that...I'll definitely have to mention that to our EMS supervisor and see what he says about it! That would be absolutely wonderful if we could get those. Thanks for the info.


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## Seedbird800 (Nov 8, 2010)

No worries

Send me a PM if you want more information.


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## Cohn (Nov 8, 2010)

I am on the old fashion paper. And unlike what someone put on page 1 we have no plans on moving to computer system now or in the future.


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## Seedbird800 (Nov 8, 2010)

Cohn said:


> I am on the old fashion paper. And unlike what someone put on page 1 we have no plans on moving to computer system now or in the future.



If you could use a pen that enabled you to write on paper that converted your hand writing into text would you use it?


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## Cohn (Nov 8, 2010)

Seedbird800 said:


> If you could use a pen that enabled you to write on paper that converted your hand writing into text would you use it?



LOL if there was something that can comprehend my fast handwriting then it will make millions in this field, I usually finish my writing later when I can slow down and write at my pace.

That would be a cool object only if I had somewhere to put said text.


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## Seedbird800 (Nov 8, 2010)

Cohn said:


> LOL if there was something that can comprehend my fast handwriting then it will make millions in this field, I usually finish my writing later when I can slow down and write at my pace.
> 
> That would be a cool object only if I had somewhere to put said text.



check out the SyncPen from http://www.emscharts.com


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## Cohn (Nov 8, 2010)

Seedbird800 said:


> check out the SyncPen from http://www.emscharts.com



We would also need the money for durable lap tops


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## Seedbird800 (Nov 8, 2010)

I think the whole point of the pen is that you don't need the laptops


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## Cohn (Nov 8, 2010)

Seedbird800 said:


> I think the whole point of the pen is that you don't need the laptops



well then why would we ever bother having it recorded for word?


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## TraprMike (Nov 9, 2010)

Seedbird800 said:


> If you could use a pen that enabled you to write on paper that converted your hand writing into text would you use it?



the narrative isn't the problem, it's the 35+ tabs and screens you have to cipher through .. paper we have 2 pages, and those are boxes to check. takes about 2 minutes to make your X..  The third page is narrative. 

paper all the way for me..


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