Allscripts Enterprise EHR. Front Desk Reference Manual

Transcription

1 Allscripts Enterprise EHR Front Desk Reference Manual

2 Contents CHAPTER 1: BASIC NAVIGATION... 1 Logging In/Logging out... 1 Workplace... 2 Select Patient... 3 Patient Banner... 5 Patient Profile... 5 Clinical Desktop... 6 Clinical Toolbar... 7 Chapter 2 Appointment Schedules... 8 Daily Schedule... 8 User Preferences... 9 Daily Preferences... 9 Changing the Schedule Date... 9 Chapter 3 Tasking Chapter 4 Call Processing Chapter 5 Help Desk. 14 ii

3 CHAPTER 1: BASIC NAVIGATION Logging In/Logging Out Allscripts Enterprise EHR is an internet-based system. The application will be launched from Internet Explorer. Note: Allscripts is not compatible with Google Chrome, Safari, Firefox or other browser applications. Do NOT use the browser buttons (back, forward, refresh) from your Internet Explorer toolbar. Only use links/buttons within the Allscripts application. To increase screen real estate: Click on the IE menu View at the top, select Full Screen (F11). Step By Step: Logging In 1. Click on CITRIX icon on desktop 2. Click on the Login ID box 3. Type your CITRIX Username and Password 4. Click on the Quillen Desktop icon 5. Click on Allscripts Enterprise icon 6. Click in the Login ID box 7. Type your username and password 8. Click one of the following: New Session or Last Session (or just hit enter. ) New Session Opens a new session of the EHR Last Session Opens the session with the last patient chart being used on this computer. Usernames and Passwords ARE case sensitive! 1

4 Locking the screen click on Lock button in upper right-hand corner of screen. Unlocking the screen-to unlock a locked Enterprise EHR session, enter your password in the password box and click Resume. Additionally, a different user can click Exit to exit the locked session and enter their own password. Logging off To log off, click the Logoff button in the upper-right-hand corner of screen. Do not click the X at the top corner of the window instead of logging off. Site Location Selection For users that practice from multiple sites/locations, a Site Selector screen will appear and require a specific site to be selected prior to launching a session. The user name and site location are always displayed in the lower left-side of the screen for reference. Workplace The workplace is defined by the user role (Front Desk, Clinical Staff, etc.) and varies by role. As a front desk user, your workplace should say Front Desk in the upper left-hand corner of your screen. This defines everything that the user sees on the screen (according to security privileges) including the Vertical and Horizontal Toolbars. Upon login, you will be directed to the main default screen that is assigned to your user role. You will see the role that you are assigned to (and/or have access to) in the upper left-hand corner of your screen. If you have access to multiple workplaces, you can change the role by clicking on the drop down arrow next to the role name in the upper left-hand corner of the screen. This option is only for Superusers. 2

5 Tools Menu Located in upper right-hand corner of screen. Here you can change settings (such as the font size on your toolbar), reset your password, view Keyboard shortcuts, and Show/Hide the clinical toolbar. Brief Description of Vertical and Horizontal Toolbars Vertical Toolbar (VTB) The VTB is located on the left hand side of the screen. This contains the user menus that have been assigned to your workplace. The VTB can be hidden to expand the screen and eliminate scrolling. To hide the VTB, click on the toggle button at the top Chart From this section, you will be able to access the patient s chart, your schedule, and your task list, as well as other items that are related to patient information. User Options This section allows you to view and/or change the site where you are currently practicing. Useful for physicians or staff who rotate to different offices. The Print Queue tab allows you to view any print/fax documents that you have sent. Homebase The homebase is a series of web links to a variety of useful sites. Clicking on these will open up the website in a separate window, so you can view the site while remaining logged into Allscripts. Select Patient There are two ways to pull up a patient s chart using the Select Patient function, or pulling a patient in from the daily appointment schedule by double clicking on the patient s name. Double clicking the patient s name from the schedule will take you directly into that patient s Clinical Desktop (the open chart. ) Step By Step: Select Patient 1. Click on Select Patient 2. Select Search 3. Choose the criteria by which you wish to search 4. Type in at least a few numbers or letters to begin your search 5. Click search or enter 6. Search results display at the bottom of the screen 7. Verify the patient s demographic information matches the person for whom you are searching 8. Click on the patient 9. Click Ok You can choose your default search criteria by clicking the blue personalize link in the search box. Notice the gray text listed above the type-in field that tells the format it accepts for the search. 3

6 Horizontal Toolbar (HTB) The HTB is located across the top of the screen. Each tab navigates the user to a different section. Daily The daily tab allows you to view your daily schedule. You can also pull in another provider s schedule by clicking on the blue All button and searching for the provider. You can also pull in another date in a variety of ways: Clicking along the days of the week tabs across the top of the schedule; clicking on the calendar icon next to the Date field, or clicking the black arrows to the right of the screen. These navigate the schedule forward and backward a week at a time. The icon next to the arrows will return you to the current day s appointment schedule. Clinical Desktop This is essentially the patient s open chart. Will go into more detail on this later in the session. Note This is where you will begin a note on a patient. Will go into more detail on this later in the session. Task List This is how you view and complete your tasks. Will go into more detail on this later in the session. Documents Documents can be bulk signed in this section. For example, if you ordered 5 labs/tests on a patient, and they have all come back normal, you can quickly and easily sign off on these simply by clicking sign on the bottom of the page. Appointments This shows all of the patient s upcoming appointments with physicians within the organization. Patient Lists These are lists that we can create for you. This is a nice way to keep track of your diabetic patients, or patients that you want to return for surgery follow-up, etc. If you want to have a list built for your clinic, please let us know. We can also give your nurse access to your list if you want them to be responsible for populating and managing the lists. Provider Schedules This tab allows you to view up to 4 schedules simultaneously. You may pull in your resident schedules here, or if you are a nurse and are working with multiple providers, you may view them here. You can also set defaults on this page so the same 4 providers are shown each time you log in. Patient Banner Choosing a patient from the Select Patient method described above will pull the patient s name into the Patient Banner. The patient banner displays demographic information of the patient in context. The summary of basic demographic information is created in the practice management system (Experior) and cannot be edited within Enterprise EHR. 4

7 Patient Profile The patient profile provides a complete view of the patient s demographic, insurance, and pharmacy information. Most demographics are entered in Experior; however, the pharmacy information, FYI, and Chart Alerts are entered in the EHR from the Patient Profile screen. Step By Step: View the Patient Profile 1. Select a patient 2. Click the blue i (the information icon) in the patient banner 3. The patient profile window will open. The FYI and Chart Alert The FYI and Chart Alert quickly provide pertinent information about the patient. The FYI displays a yellow icon on the patient banner when populated, and the Chart Alerts display in red on the clinical toolbar which shows on all screens. FYI - intended use is for non-urgent information about the patient. Information might include items such as patient needs an interpreter, or wheelchair needed. The front desk can add and edit FYI items. The intent is not to be used for billing/insurance information. That information should remain within the practice management system. Chart Alert intended use is for urgent clinical information such as latex allergy, or Penicillin allergy. Each patient can have up to three chart alerts. Chart alerts will automatically record all comments with user name, and entered date/time stamp. Front desk folks will be able to read chart alerts, but do not have access to create them. If a user enters a chart alert message(s) for the selected patient on the Patient Profile form (the blue i), the system displays the message(s) in red text on the Clinical Toolbar. 5

8 Clinical Information This section contains clinical demographic information such as directives and clinical trials. Within the clinical information section, you can also view the patient s demographic information, their employer and contact info, insurance, Rx benefit plan, pharmacy, and associated providers. The majority of this information will pull in from Experior. Pharmacy - The system allows for a patient to have up to four retail pharmacies and up to four mailorder pharmacies in their record. Step By Step: Adding a new pharmacy 1. From the patient profile window, scroll to the Pharmacy information window 2. Click on the binoculars next to Retail Pharmacy 3. Search for the desired pharmacy Type in at least three letters of the name of the pharmacy 4. Type in at least one other criteria (recommend using the zip code) **Optional 5. Click Enter 6. Choose the correct pharmacy from the results 7. Click OK Sometimes less information in the search fields will get you more accurate results. For example, if you type in the address: 123 North Street but it is listed in the system as 123 N. St., you will not get any results. Also, the most recently added pharmacy becomes the default pharmacy. To change the default pharmacy, click on the pharmacy you want as the default and then click the Make Default button. Associated Providers Use this section of the Patient Profile to specify the role/relationship of each provider associated with a patient such as the primary care provider, attending MD, resident, etc. Clinical Desktop This workspace provides the user access to all areas of a patient s record. It is highly configurable by user by the use of Preferences, sorts, and filters. The Clinical Desktop is comprised of the following elements: Clinical Desktop View: Indicates the clinical desktop configuration component layout, what is visible. Clinical Toolbar Always docked on the Clinical Desktop and used by clinicians and Physicians, provides a menu of shortcut icons to quickly navigate to various clinical workspaces for commonly used actions. Components Configurable workspaces including Problem, Encounter, Meds/Orders, Allergies, Chart Viewer, Patient Worklist, and HMP. 6

9 Clinical Toolbar The Clinical Toolbar provides a menu of shortcut icons to quickly navigate to various workspaces for commonly used actions. Depending on the screen you are in, the toolbar will either be docked directly below the patient banner or will be floating over the current screen. You can close the floating Clinical Toolbar by clicking the X in the upper right corner. To open the floating Clinical Toolbar again, click Tools (above the horizontal toolbar), and then select Show/Hide Clinical Toolbar. Generally, the front desk won t be using the clinical toolbar, so it is suggested that you hide this upon login in order to avoid confusion. The one exception to this rule concerns the Patient Location and the Patient Status. On the Daily Schedule, you will see two fields Patient Location and Patient Status. These fields may need to be changed by the front desk, depending upon your office s workflow. Pat Loc - This control is a dropdown list. When the user clicks it, the system displays a list of locations where the patient can be located. For example, it could be a room number or a description such as waiting room or vitals room. The locations that are available correspond to the site to which you ve logged in. Status - Indicates the selected patient s status. The status is followed by a date and time stamp that indicates the last time the status was updated. Checking in the patient will still be done in Experior; however, your office workflow may request that you change the Patient Status and the Patient Location in Allscripts. Commit button Another item on the Clinical Toolbar that you may need to be aware of is the Commit button. Any time changes are made to the patient s chart (a medication changed, a lab ordered, etc.), the Commit button on the Clinical Toolbar will turn yellow. Clicking Commit will save the changes to the patient s chart. If the button is grayed out, then no new information needs to be saved. Chapter 2 Appointment Schedules 7

10 Many workflows begin by selecting a patient directly off of the appointment schedule. A schedule can be viewed for one provider or multiple providers simultaneously. Additional information can be accessed from the schedule such as patient demographics, appointment details, encounter tracking, and patient appt. history. Appointments are populated from the PMS. Daily Schedule The daily schedule is a view of a provider s appointment schedule for any given day. To display a schedule of a specific provider, you can use the dropdown button next to the field to display a provider that you have previously searched on, or you can click the blue All button next to it to search for the specific provider. Step By Step: Viewing a Single Provider Schedule 1. From the Chart menu in the VTB, click on the Daily tab 2. To search for a provider, click the blue All button next to Provider field 3. Type in the last name of the provider in the Search box 4. Click Go 5. Click on the provider name that you are looking for from the results 6. Click Ok 7. The provider s schedule of appointments will display You can see a list of all of the providers by leaving the Search For field blank and just clicking Go. 8

11 User Preferences Preferences can be set at the user level by clicking on the blue links (Personalize) in the top of the schedule. Both will take you the same Personalize window. Daily Preferences applies to the Daily schedule tab from the HTB. Items that can be changed: Default Provider defaults to this provider when the daily schedule is accessed. Automatic Refresh - # of minutes to have the schedule refresh automatically to display changes Double-Click Action indicates where you are directed when you double click on a patient s appointment. It is recommended to set this on Chart based upon the intended workflows. Schedule contents ability to filter on certain appointments based upon the appointment status (arrived, pending, etc.) All Provider View Allows the user to combine the schedules of up to 20 providers into one schedule for easier management of multiple schedules. Changing the Schedule Date The schedule will default to today s date; however there are several options to navigate to other dates. Type directly into the Date box Click on the calendar button next to the date field Click on a day of the week which will be the days of the current week Click the Go To Today button Click on arrows to go ahead or back week by week Appointment Details: The schedule displays indicators giving the user a quick view of the appointment status: N indicates note status. A piece of paper symbol indicates that a note has been started but not finalized. A paper symbol with a checkmark over it indicates that the note has been completed/finalized. A appointment status. Pen is prior to the patient arriving for the appointment. Arr indicates the patient has checked in for the appointment. Pt Loc patient location (waiting room, Exam Rm 1, etc.). Manually changed. Pt Status patient status (nurse ready, provider ready, roomed, departed, etc.). Manually changed. Time time of the patient appointment Patient patient name (last,first) MRN medical record number Type appointment type set at the time the appointment is made. Dur duration of appointment scheduled (15 min., 30 min., etc.) Tasks - # of active tasks for this specific patient. Comments comments such as the reason for the appt. which is entered at the time the appt. is entered. Additional schedule screen components: 9

12 Top of screen AM, PM, Total this indicates the number of appointments scheduled in the morning, the afternoon, and total for the day. Last Updated this indicates the date/time that the screen was last refreshed. The screen can always be manually updated/refreshed by clicking on the blue button Bottom of screen Patient insurance displays from information entered in the Practice Management System Patient Profile launches the same Patient Profile window that the blue i launches. Appt Details displays additional appointment details Patient Appts-lists patients appointments past, present, and future Print Schedule, Print Chart printing ability from schedule New Task create a new task from schedule Provider Schedules tab Another schedule option which exists is found on the Provider Schedules tab on the HTB. This section allows you to view up to 4 provider schedules simultaneously. Pulling in a provider schedule works the same way as it does on the Daily schedule tab you can click on the blue All button, and search for the desired provider, or you can check the drop down box to see if the provider s name is populated in the search field. To set default schedules for these fields, click on the blue Personalize hyperlink in the upper right-hand corner, and the same Personalize box will appear that you saw in the Daily schedule. This time, however, you ll be working out of the panel on the right. Click on the blue All button, choose your physician, and repeat in the remaining 3 fields (if desired). Click OK. Provider Schedules Preferences applies to Provider Schedules tab from the HTB. This tab allows the user to view up to 4 separate provider schedules on one screen. The personalization options can be set as in the Daily schedule (by clicking on the blue Personalize hyperlink), so the user can set up default providers for each of the 4 schedules that are viewed on the screen. Chapter 3 Tasking Working with Tasks A task is a request to perform an action or supply information that may or may not be associated with a patient. However, it is highly recommended that all tasks are associated with a patient and not personal in nature. Tasks can go to a person or a team, be generated almost anywhere within the EHR application, and are generated in two ways: 10

13 System-Generated tasks: tasks that Enterprise EHR generates based on specific workflows. System-Generated tasks typically drop-off a user s task list automatically once the user completes the action specified by the task. Manual tasks: tasks that are initiated and sent by one user to another within Enterprise EHR. Once the action specified by the task has been completed, the user must manually complete the task in order to have the task removed from the task list. Tasks are stored in specific lists aka Views. Specific Views are assigned to users depending on their role within the organization. Task List Workspace The following table describes the columns on the Task List page: Column Description P (Priority) Level of urgency. Indicates a task that should be completed on an Urgent basis. D Task Patient Assigned To Created By Created On Status Due MRN Indicates a task that should be completed ASAP. No indicator displayed indicates a task that should be completed on a Routine basis (within seven days). (Delegated) Indicates whether responsibility for the task has been delegated. Describes the particular information or action required by the task. Patient with whom the task is associated. If blank, the task is not associated with a specific patient. Person or team to whom "ownership" of the task is assigned. Indicates whether the task was manually created (name of the person who created the task) or system-generated. Date and time the task was created. Task status: Active Indicates a task for which the activate date has been reached, but has not yet been completed. In Progress Indicates a task that is currently being performed. Complete Indicates a task that has been performed or completed. Inactive Indicates a task for which the activate date has not yet been reached. Removed Indicates a task which has been removed rather than completed. Task due status. Indicates a task for which the due date has been reached, but has not yet been completed. No indicator displayed indicates a task for which the due date has not yet been reached. Medical Record Number (MRN) of the patient with whom the task is associated. Creating Tasks 11

14 Working and Completing the Task List The task list can be sorted by the various columns and the following options are available: Details In Progress Go To Reassign Remove Reply Copy to Note Undelegate Print List Print Task Original Done Highlighting a task and selecting Details displays the Task Details page. Selecting the task and clicking In Progress displays who performed this action in the Comments box. Selecting the task and clicking Go To displays the workspace from which a task's action must be performed. For example, if you are working a Sign Note task, clicking Go To displays the Note Authoring Workspace. Selecting the task and clicking Reassign allows you to send the task to a specific user or team. Selecting the task and clicking Remove allows you to remove the task from the system. The system requires that you indicate the reason why you are removing the task, and you can enter additional Comments, as needed. Selecting the task and clicking Reply allows you to send a reply back to the original sender of the task. You can also edit the task's priority if appropriate. Selecting the task and clicking Copy to Note allows the task to be copied into a note. If a note is not in context, then the system displays the Note Selector for selecting the appropriate note. Selecting the task and clicking Undelegate will send the task back to the Assigned To user or provider. You must manually remove the task after undelegating it. (This only undelegates the one task selected and not all future tasks.) Selecting Print List prints the entire task list for that particular view. Highlighting a task and selecting Print Task will print the task. When a user receives a notification that a task was completed, they highlight the task and click Original to view the original task previously sent. Selecting Done will complete the task and remove it from the active list. The system displays the Done button instead of Go To if a task must be performed manually outside of Enterprise EHR. In this case, click Done to complete the task. This action does not delete the task from the system; it changes the status of the task to Removed. 12

15 Chapter 4 Call Processing Documenting a call The Call Processing feature allows the user to document incoming calls and route them to the appropriate person or team as a task. Calls may be processed whether or not a patient is associated with a call. Text templates are also available for improved efficiency of capturing call data. Information that can be entered in the Call Processing workspace: Patient If a patient is in context (in the Patient Banner), the system will assume the call is regarding the current patient and will default the Patient name and Prev Appt, if available. User can populate a patient by clicking on Select Patient, or Clear Patient to remove the current patient information. Patient is Caller Indicates the patient in context is the caller. When this box is selected, the patient information will populate the Caller and Relation fields. Date and Time of Call Indicates the date and time on which the call was received. The default value for new calls is the current date and time. Caller Indicates the name of the person initiating the call. If the caller is the patient (and thus, the Patient is Caller option is selected), then this information is completed automatically. Phone Number How to reach the caller. If the Patient is Caller checkbox is selected, the phone number populates automatically. This information originates from and must be updated in the Practice Management System. Relation Indicates the relationship of the caller to the patient. For example, if the patient is the caller, then the system displays Self. Route To options Indicates the user or team responsible for completing any tasks resulting from the call. If the User option is selected, then the default value is the current user's name or is indicated by the user preference on the Personalize page. Reason for Call - Select a reason for the call from the provided options in the drop down menu. Comments Details can be free texted into the comments box or a text template can be used to check off information. 13

16 Step By Step: Documenting a Call 1. Click on Call Processing from the VTB. This will open the Call Process page. 2. Select Patient is Caller check box. 3. Route to a User by clicking the radio button. 4. Choose your provider from the dropdown menu. 5. In the Reason For Call dropdown list, select Medical Complaint. 6. In the Comments section, click on the Text Templates button at the bottom of the screen, or free text in this section. 7. From the column on the right that lists the various templates, select Medical Complaint. 8. Fill in information: to select something, you double-click on it to bold it. 9. Click OK. 10. Copy to Task. 11. Define a task in the dropdown menu. 12. Click OK. Unfinished Calls When a call cannot be completed at the time it was started the user can click the Finish Later button which will place the call on the Unfinished Calls page to be accessed and/or finished at another time. An example of why this would be used is if a call was cut short or dropped in the middle of capturing the call s data. Clicking Finish Later enables a user to complete the call that was interrupted earlier. 14

17 Clicking on the Unfinished Calls tab from the HTB displays Unfinished Calls Page. The user can view just their unfinished calls or all calls, if security permits. 15

18 Several actions may be taken from the Unfinished Calls page. Highlight the incomplete call to activate the buttons across the bottom of the page to work the call. The information captured displays in the bottom portion of the screen. Delete Enables a user to delete the in progress call. Start New Navigates the user away from the Unfinished Calls page to the Call Process page to begin capturing new call data. Edit Clicking the Edit button navigates to the Call Process page with the incomplete call data and provides the ability to continue capturing call data. Copy to Note Enables the user to copy the captured call data to a Note and stored in the patient s record. Copy to Task Provides the ability to send the captured call data as a task for a person or team to act upon. Worklists A Worklist is a specific workspace that contains order and result items and provides an efficient way to monitor, track and work the orders. The Worklist allows the user to address the order or result from a single workspace, regardless of the order status, without the need of assigning a task to it to facilitate user interaction. Worklist items and tasks have different functionalities. Tasks may or may not pertain to a patient and are assigned to an owner. Worklist items are linked to a specific patient. In most cases, it is recommended that the user check the Task list first. 16

19 Cross-Patient Worklist Step By Step: Viewing the Cross-Patient Worklist 1. From the Vertical toolbar, select Front Desk. 2. From the Horizontal toolbar, click the Worklist tab. 3. Select the appropriate View from the drop-down menu. A list of patients displays on the left-side of the page. 4. Highlight the desired patient name. A list of items requiring attention displays. It s important to pay attention to the list of items as they may or may not all pertain to you. 17

20 Help Desk Support Utilizing the Help Desk is simple: Select the QITS Help icon on the desktop Or Send an to: Or Call: Using the Help Desk is the best way to contact support and provide tracking for requests. Just choose EHR Support in the Request Type field and fill out the Request Detail field. Don t forget to add your location, and then Save. NOTE: To practice from home, launch Internet Explorer Browser and type in nophi.qetsu.org in the browser window (no www or http). 18