Topics Covered in Class: Page #

Topics Covered in Class: Page # Starting Powerchart 2 Signing In, Securing Session 3 Finding a Patient 4-5 The Banner 6 Frequently Used Pages of the Chart 7 Clinical Notes page 8-9 Form Browser page 10 I&O/Documentation page 10 MAR & MAR Summary pages 11 Orders/Plan of Care page 12-13 Patient Info page 14 Patient Overview page 15 Results page 16-21 Inpatient Summary Page 22 Therapy Specific Pages 23-24 Customize Your View 25-32 Security 33 Who to Contact for Help Hardware Malfunctions; Password Resets; Application Support: Springfield Help Desk: 269-3153 Revised January 2012

1. Click START button 2. Hover over Programs 3. Click Citrix Powerchart Starting Cerner Powerchart Opening Powerchart OR 1. Click Citrix icon in the bottom right corner of the screen 2. Hover over Applications 3. Click Citrix Powerchart You may see the connection progress window. 2

Sign In to Cerner Powerchart ALWAYS PROTECT YOUR PASSWORD Signing In & Securing Session 1. To sign in to Cerner, click in the User Name field, type your User Name 2. The initial password is your User Name the first time you sign in. You will be prompted to change your password using a minimum of 8 characters. This needs to be a complex password -- a mix of upper/lowercase letters, a number, and a special character or symbol. Secure Session Use secure session if leaving the computer for a brief period. To secure the session, right click on the title bar (blue bar at the top) of the Organizer. Left click Secure Session. This keeps your session protected and no one else can use your sign on. This will minimize the application. To re-open: click your username in the Task Bar at the bottom of the PC. Type your password and click OK. 3

Powerchart Organizer Finding a patient The Find Patient area is on the right side just below the toolbar. Type in the last name search window, or use the down arrow to change search to MRN. Finding a Patient To open a recently viewed patient s chart: Left click Patient in the toolbar, hover over Recent. Powerchart will remember up to 9 previous charts. Once the patient has been clicked to open it, Powerchart will then prompt to pick from all available encounters for that patient again. Multi-Patient Task List : Shows the task for each patient. Patient List: Displays tabs for each nursing unit ** For instructions on setting up your tabs, see page 25-32 in this handout ** Patient Access List ~ PAL: Displays an entire unit or just your assigned patients. 4

Powerchart Organizer Finding a patient (not on a list) Finding a Patient Click the Binoculars. Type in the patient name (last name, first few letters of the first name) or search by MRN, SSN, Birth Date or Financial Number to find the patient. Press Enter key or click Search. Select the correct name (top pane) AND THEN select the appropriate financial number for the encounter to view (bottom pane). Click OK. Staff must remember to check to make sure they have the correct encounter. DO NOT select an encounter based on the DATE! The system will not give a warning if an order is entered on a future date. Select an encounter based on the FIN NBR. Use the Med Service, Facility, and Nursing Location to help in the selection. Entering orders on the wrong Encounter can delay care for the patient. Scheduling on the wrong Encounter can cause problems with charting/documentation. Ordering and Charting on the wrong Encounter can cause problems with the patient s bill. Ordering and Charting on the wrong Encounter causes more work for staff. 5

Banner The Banner The Banner displays information such as patient name, DOB, MRN (Medical Record Number), Gender, Allergies, Location, Age and Financial Number. 1001-01 Remember, the patient s financial number (FIN NBR) always shows in the Banner once their chart is open. And the Nursing Location also shows in the Banner. To double check the visit selected is the correct one, click the location in the Banner. The box shown below will open. It displays the visit currently selected with an X on the left. It will also display the Facility, Nursing Location, Med Service, and Visit (Encounter) Type. To change encounters, double click the correct encounter. A dialogue box will display to confirm the change of encounters. The X will then move to the selected encounter. 6

Frequently Used Pages of the Patient Chart: Accessible by clicking Chart in the Toolbar or hovering over Menu on the left. (Not all users will have access to all of these pages.) Clinical Notes Form Browser I&O/Documentation MAR MAR Summary Orders/Plan of Care Patient Info Patient Overview Results Inpatient Summary OT, PT, and SLP have 2 additional pages available to them. 7

Clinical Notes page For viewing the scanned medical records and dictated documents Clinical Notes Document folders will display in the navigational area. Double click on the folder to display the files within it. Double click on the file to view. The large up/down arrows can be utilized to navigate through the document folders. Folders can be sorted by the following category: Type ~ Category of Document (i.e. EKG Reports, Facesheet, History and Physical). Status ~ Verified, Modified, or Transcribed status (used by Health Information Management). Date ~ Patient s admission date or entry date of form. Performed by ~ Physician name dictating the document/performing the procedure. Encounter ~ Encounter date. Right click in the navigational area opens a menu. This can be used to change the search criteria, to sort folders and to view the color legend. 8

Clinical Notes page Clinical Notes For viewing some results. Scanned documents, images, transcription, information from other programs (Springfield s North and South E.R.s), therapy, and surgery charting. Document folders will display in the navigational area. Double click on the folder to display the files within it. Double click on the file to view. The large up/down arrows can be utilized to navigate through the document folders. Folders can be sorted by the following category: Type ~ Category of Document (i.e. EKG Reports, Facesheet, History and Physical). Status ~ Verified, Modified, or Transcribed status (used by Health Information Management). Date ~ Patient s admission date or entry date of form. Performed by ~ Physician name dictating the document/performing the procedure. Encounter ~ Encounter date. To increase or decrease the number of results, click the arrows on either end of the filter bar. Decreases by 1 document Changing the number of results and viewing the result details Increases by 1 document OR right click on the filter bar, select Change Search Criteria another window opens to select specific date range or number of results. Scanned documents show a toolbar at the bottom of the page: First Page Previous Page Next Page Last Page The displayed page number. You may type in the desired page. Zoom In Zoom Out Adjust Fit Rotate Left Right Print 9

Form Browser page Used to finish, modify or unchart forms Form Browser/ I&O These forms can be sorted by date, form, status, encounter date, or encounter form by clicking the drop down arrow by Sort by. Status of forms: Verified form was signed. Modified - form was signed and then additions/modification were made to the form. In Progress - form was saved but not signed. In Error - form was signed or saved and then uncharted (red line drawn through it). I&O / Documentation page View charted information 10

MAR & MAR Summary pages MAR & MAR Summary Once medications have been documented in Powerchart, the documentation shows on the MAR. MAR Summary shows more data with less scrolling. MAR Summary is a View Only page. 11

Orders/Plan of Care page Displays orders Orders/Plan of Care Display of Orders and Order Details Orders with a indicate the order is in Active status. Deselecting the in the View pane will hide that particular order category. Rows of the Display Blue rows display the Category names. White rows display the orders placed within each Category. Columns of the Display ( ) Indicates an active order. If no checkmark is present, the order is in another status. (+) Plus indicates continuing orders. Click to expand. Status ~ Displays as Ordered, Completed, or Canceled. (Home medications listed display a status of Documented) Details ~ Displays details such as date, time, frequency and ordering priority. Ordering Physician ~ Displays who requested the order. The dropdown in the Display box can be selected to filter the orders being viewed. Options include statues such as: All Orders 5 Days Back, Active Orders, Completed Orders, Continuing Orders 12

Orders/Plan of Care page Current List of Home Meds Orders/Plan of Care Current list of home medications is documented on the Orders/Plan of Care page and is displayed with the Status of Documented. Those medications do not have check boxes to the left of them. 13

Patient Info Patient Info page View demographics, who has accessed patient s chart, allergies, or change encounters (visit information). This information is READ ONLY and comes from the SMS/Invision registration system. Patient Demographics ~ Displays basic patient information for the selected visit. Relationship Audit ~ shows everyone who has opened the chart as well as all physicians registered to the patient. Pt/Next of Kin Info ~ shows all the patient s different visits as well as next of kin information for the selected visit. The encounter or visit can be changed from here (similar to the Banner). Allergies ~ shows all the patient s documented allergies. 14

Patient Overview page View patient s allergies, recent vital signs, medical and surgical history, home medications. Patient Overview The items that appear on this page are somewhat specific to your discipline. 15

Results Results page View information such as test results, nursing documentation, or reports. ALL RESULTS SHOW ON THIS PAGE.. Change the flowsheet displayed by clicking the dropdown in the Flowsheet box. The Navigator can be used to move to a specific section without scrolling. To hide a specific category, deselect the next to the category name. 16

Results Results page Flowsheet values and marking the results as reviewed Flowsheet Values: C = critical value (displays red) H = high value L = low value A = abnormal non-numeric result (f) = indicates a footnote or a comment is attached to the result (e) = indicates an edited result Blue results = unreviewed value. Black results = indicates the results has been reviewed. Click the eye button in the toolbar to change the blue (unreviewed) results to black (reviewed). This Bookmarks the results and is specific to your sign on. 17

Results Results page Changing the number of results and viewing the result details To increase or decrease the number of results, click the arrows on either end of the filter bar. Decreases by 100 results. Increases by 100 results. OR right click on the filter bar, select Change Search Criteria another window opens to select specific date range or number of results. To view details about a result, right click the result, select View Details. Another window opens displaying two tabs Result (additional information) and Action List (tracking the documentation). 18

Results Results page Viewing the result details and changing the display view To view comments about a result, right click the result, select View Comments. Another window opens displaying three tabs Result (additional information), Comments (displays inserted comment) and Action List (tracking the documentation). To change the display view by Table, Group or List, select the corresponding round radio button. 19

Results Results page Graph results and using the Flowsheet Seeker To graph, click the gray box next to the desired results. Next, click the Graph button in the tool bar. Another window opens graphing the results. Note ~ only numeric results may be graphed. Flowsheet Seeker button = zone in on specific results. Click the Flowsheet Seeker button. Another window opens allowing you to maneuver through the flowsheet. Left click the outlined box (continue to hold the left click) and move it within the window. As the outlined box moves to a selected area, so does the flowsheet. 20

Results Results page Searching for specific results using the Ellipsis Button To search for a specific results, click the ellipsis button for a procedure selection box. Another window opens, type the order name or result to view. Press Enter. A list will display. Click on the desired selection. Click OK. The desired item will now display. To return to the original view, click the drop down arrow, select All Results Flowsheet. 21

Inpatient Summary page Inpatient Summary This page displays a summary of some of the patient s past and present information/history It is important to note that this page is not a complete source of visit information. 22

Therapy Specific Pages: Patient Summary pages These pages will display a summary of the patient s care. All 3 pages have: Patient Summary Therapy Specific Pages: Each specific page will also contain the short term goals for that area. 23

Treatment Summary Therapy Specific Pages: Treatment Summary pages These pages will display a summary of the patient s treatment(s). 24

Customize Your View The following pages will show how to set preferences throughout Powerchart. Customize Your Toolbar: MENU ORGANIZER TOOLBAR LINK TOOLBAR ACTION TOOLBAR You can move a toolbar to a different location and rearrange the icon order on the toolbar. To Move a Toolbar 1. Position the mouse pointer over the toolbar move handle, click & hold. 2. When the four-sided arrow displays, drag the toolbar to its new location. To Move Icons 1. Click the Toolbar Options down arrow at the right end of the toolbar. 2. Hover over Add or Remove Buttons, then click Customize. This opens Customize Tool Bars window 3. To change the order of an icon, position the pointer on the icon, click & hold, then drag the icon to the new position. Repeat for each icon to be moved. 4. Close the Customize Tool Bars window. Note: Icons cannot be moved to other toolbars. Doing so will result in this message: 25

Customize Your View con t Show/Hide Menu Options will present in alphabetical order and will vary based on position. (Options are also found in the Chart menu.) Click the push pin icon on the Menu to turn Auto Hide on or off. Pin facing left indicates Auto Hide is on. Menu displays or retracts according to your mouse position. Pin facing down indicates Auto Hide is off. Menu displays and remains stationary. Expanding column width on PAL: Hover your mouse in the grey area between column sections. Your mouse becomes a two-directional arrow. Click the mouse and while holding it clicked, drag the columns to a wider or narrower width. 26

Customize Your View con t Adding Results to the PAL Right click on the column on the PAL where you want to add new items, and then click Insert Column. Click on the column choice to add, click Next. A new box will open. Double click the option you want to add. Additional sub-menus might then display. Click to select the correct one, click Next. For more steps on adding columns to the PAL, go to: http://intranet/it/cerner%20quick%20tips/adding%20columns%20to%20the%20pal.pdf 27

Customize Your View con t Selecting Columns on the Orders/Plan of Care page: On the left side of the page, click Customize View. Additional column display choices show on the left. A new box displays the columns showing on the page in the box on the right. Click the item to display, then click the Add button to move it to the box on the right. On the bottom of the box, sorting by Clinical Category and then by Date will display the last time the order was updated. Click OK when all preferences are set. The order (top to bottom) that the list displays in the right box, is the order that the items will appear (left to right) on the Orders page. 28

Customize Your View con t Setting up Tabs on the Patient List: Patient List: To create a tab for specific nursing unit(s) 1.Click the wrench button in the toolbar. 2. Click the New button.

Setting up Tabs on the Patient List (con t) 3. Click Location. 4. Click Next at the bottom of the window. 5. Double click Locations to open the folder. 30

Setting up Tabs on the Patient List (con t) 6. Double click CoxHealth Systems Facility. 7. Double click the appropriate building (e.g. North, South). 8. Click the box to put a checkmark next to the name of the nursing unit. The name of the unit will appear in the bar on the bottom of the page. Click Finish. 31

Setting up Tabs on the Patient List (con t) 9. Click the nursing unit to add a tab for it on in the Available lists area. Then click the arrow pointing right. 10. Click OK. The nursing unit tab will now display on Patient List. 11. That unit now displays a tab with its name.

Keeping Your Log In Secure Security Keeping your access to PowerChart secure is your responsibility. Here are some tips : When walking away from the computer, be sure to log out of PowerChart OR Secure your Session. Do not write down your username or password. Do not let someone else use your access (e.g., for training purposes ). If you suspect your password has been compromised, be sure to change it AND call the Help Desk to report it. Single Sign On means your badge can be used to gain entry to PowerChart. This means you must be sure to keep your badge secure so it cannot be used by someone else to gain access under your log in. Do not print things from PowerChart. It is not possible to track or record who views items printed out from the EHR. Questions? Email Education-Cerner@coxhealth.com 33