Centricity Electronic Medical Record 9.0 Setup Training Manual

Transcription

GE Healthcare
Centricity Electronic
Medical Record 9.0
Setup Training
Manual
1
Confidential and Proprietary Information
Confidentiality and Proprietary Rights and Limitations and Conditions of Use
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Electric Company (“GE Healthcare”) and is furnished to you, a current GE
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both the patient and GE Healthcare before you disclose sensitive patient
information to GE Healthcare.
Trademarks
GE, the GE Monogram, and Centricity are trademarks of General Electric Company.
All other product names and logos are trademarks or registered trademarks of their
respective companies
Copyright Notice
Copyright 2009 General Electric Company. All rights reserved.
Disclaimers
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Clinical professionals are expected to know the medical procedures, practices and
terminology required to monitor patients. Operation of the product should neither
circumvent nor take precedence over required patient care, nor should it impede the
human intervention of attending nurses, physicians or other medical personnel in a
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GE Healthcare IT
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www.gehealthcare.com
2
Agenda Day 1
9:00 – 10:15
“Superuser” User & Password
Core Setup
•Lesson 1: Locations of Care
•Lesson 2: Users Folder
10:15 – 10:30
Break
10:30-12:00
Core Setup (continued)
•Lesson 3: Appointments Folder
Clinical Setup
•Lesson 4: Chart Folder
12:00-1:00
Lunch
1:00-2:30
Clinical Setup (continued)
•Lesson 5: Chart Documents Folder
•Lesson 6: Desktop Folder
2:30-2:45
Break
2:45-5:00
Clinical Setup (continued)
•Lesson 7: Handouts Folder
•Lesson 8: Letters Folder
3
Agenda Day 2
9:00 – 10:15
General Configuration
•Lesson 9: Registration Folder
•Lesson 10: Reports Folder
•Lesson 11: System Folder
10:15 – 10:30
Break
10:30-12:00
•Lesson 12: Web Services
•Lesson 13: Orders Setup
12:00-1:00
Lunch
1:00-2:30
•Lesson 13: Orders Setup (cont’d.)
2:30-2:45
Break
2:45-5:00
•Lesson 14: Review Link Logic Setup
•Lesson 15: Preferences
•Lesson 16: Privileges
4
Log-in Screen
Centricity Electronic Medical Record System Setup
The Centricity EMR Login screen is the beginning location for accessing the software.
To Login:
1) Enter your User ID and password. The password displays as asterisks (*) so it can’t be
seen. The password is case sensitive. NOTE: You have the opportunity to change your
password – note your new password, as it is user-defined and is not kept in a master file.
You can use the Tab key or the mouse to advance the cursor from field to field.
2) The default Location of Care will automatically populate based on the user’s settings.
Verify the correct location displays in this field.
3) When all fields are populated press the Enter Key or click OK to login.
If you are unable to login because of an incorrect user id or password, the field that is
incorrect (either user id or password) appears highlighted in blue.
The Exit Button will close the Centricity Physician Office EMR software.
NOTE: The application contains a user named “SUPERUSER” who has full-functionality
and administrative access to the application.
5
Centricity EMR 9.0: System Set Up
This part of the
training will
focus on the
Settings tab of
setup.
Centricity EMR Setup is divided into three sections:
•
Preferences
•
Settings
•
Privileges
To Begin Setup:
1) Click the Go menu
2) Click Setup
3) Click Settings
Items in the Settings section are completed first, followed by Preferences
& Privileges.
Please note: Prior to Centricity EMR set up, consider your Practice’s
key decisions in order to support the intent of the installation.
6
Lesson 1: Locations of Care
Learning Objectives:
•Orientation of Setup Features
•Systems Folder
•Determine Locations of Care
•Add Locations of Care
•Edit Locations of Care
7
Locations of Care
Information Regarding Locations of Care:
• Each Location of Care will have a name and an abbreviation.
• Patients entered in the EMR can reside at a Location of Care.
• Users will have a home Location of Care.
• Privileges set up in the EMR are affected by Location of Care.
8
Create Locations of Care
Please note:
Prior to adding
a new Location
of Care, make
sure there is an
“All” location
placeholder at
the top of the
hierarchy
To allow for system expansion, it is important to make sure that the “All”
Location of Care remains at the top of the hierarchy.
To Add a New Location of Care:
1) From the Settings tab, expand the System Folder, and Select Locations of Care.
2) Click the New button.
3) Complete the Name, Abbreviation, Parent Location, Address, City, State, Zip
and Phone
4) Optional: Add Fax, Email, Contact, and Contact By
Note: Once a location of care is set up, you cannot remove it if it is the
home location for any patients or users.
9
Lesson 2: Users Folder
•Users Folder
•Create New or Edit Groups
•Create New or Edit Job Titles
•Create New or Edit Roles
•Create New or Edit Users (including activation/expiration date)
•Create New or Edit Specialties
10
Users Folder
To Access the Users Folder:
1) Select Go>Setup>Settings
2) Expand the Users folder (alphabetical order) by clicking the “+” sign next to the
Yellow Users Folder.
3) Settings for 5 items appear:
•
Groups
•
Job Titles
•
Roles
•
Users
•
Specialties
11
Groups
Groups are associated to individual users in Centricity EMR. Groups are used
when setting up system preferences.
To Create Groups:
1) Highlight the Groups item under the yellow User folder
2) Click New to type the name of the group in the new window
3) To save the group name, click OK
12
Job Titles
Job Titles are required in order to create a new user in Centricity EMR.
Each user can have one job title.
To Create Job Titles:
1) Highlight the Job Titles item under the yellow User folder
2) Click New to type the name of the job title in the new window
3) To save the job title, click OK
13
Roles
Roles are associated to individual users within Centricity EMR. An individual user
can have up to 5 roles. Roles are used for setting system privileges.
To Create Roles:
1) Highlight the Roles item under the yellow User folder
2) Click New to type the name of the role in the new window
3) To save the role, click OK
14
Users
A user can be created under their Home location of care.
To Create a User:
1) Highlight the user’s home location of care
2) Click the new button
3) The New user dialog box will appear. Fill out the following areas:
• Last Name, First Name, Middle Name (if applicable)
• Phone Number
• Verify Home Location (defaults based on where user is being created)
• Authorized Locations (locations in which users can view associated documents,
appointments, and patient charts)
• User ID/ Password/ Password Verification
• Requires Password Change at Login (if the first time, you wish the user to be prompted
to set a new password in which the user only knows)
• Group - used for setting preferences
• Job Title - required for saving the user account
• Specialty - select the user’s specialty (typically only the clinicians have a specialty
marked)*
• Roles - used for setting privileges; a user can have up to 5 roles
• DEA # - type the Drug Enforcement Agency Number; this number will print on
prescriptions
• License # - type the license number of the clinician
* NOTE: If using CCCQE forms, the specialty is required when setting up your providers.
15
Activating/Expiring User
Accounts
Activation / Expiration
Dates
You can set up user accounts ahead of time. You can also set up predefined
passwords, activation dates, and expiration dates.
To Set up Activation and Expiration Dates:
1) Go to Go>Setup>Settings>Users>Users
2) Create a new user
3) Enter the activation date
4) Enter the expiration date, as applicable. (If no date is entered, the user account
will never expire.)
User Expiration Dates:
To accommodate rotating residents or other temporary users in your organization, you can
enter a date that the user account will expire, meaning the user can no longer log into the
EMR application beyond the expiration date.
The user can access the EMR application up to and on the expiration date but not after that
date. Seven days before a user’s actual expiration date, the EMR application sends that
user a flag with a pending account expiration notice.
The EMR application then waits 30 days before making the expired user obsolete. The user
can only be made obsolete if they have no existing flags or unsigned documents.
The user you designate to receive system warning flags will receive a daily report
identifying those expired users with flags and unsigned documents.
16
Specialties
Specialties are utilized when setting up your own providers as users in
Centricity EMR. Specialities are also used when setting up the service providers
for the orders module.
To Create a Specialty:
1) Click the New button
2) Type the name of the specialty
3) Click OK to save the specialty
17
Lesson 3: Appointments
Folder
•Appointments Folder
•Create New or Edit Books
•Review Slot Sizes
•Discuss Templates
•Create New or Edit Types
18
Appointments Folder
To Access the Appointments Folder:
1) Go to Go>Setup>Settings>Appointments
2) Expand the Appointments folder (alphabetical order) by clicking the “+” sign
next to the Yellow Appointments Folder
3) Settings for 4 items appear: Books, Slot Sizes, Templates, and Types
19
Books
Books for anything that has a schedule in the practice management system are placed
under the proper location of care. Providers who practice in more than one location may
need a separate book at each location. If the same book will be used in both locations, the
appointment book needs to be placed at a higher location of care in the hierarchy.
To Add a Book:
1) Highlight the location of care under which the book will reside
2) Click the New button to add a book
3) Specify the book type as person, room, equipment, or other
4) Type the book name (must be unique with no punctuation)
5) Associate the template (only if not using practice management system)
6) Select the user
7) Route to: (Optional Feature) When the patient is arrived in the system, an update can be
routed to a user. Choose the user if desiring to use this functionality. (Note: LinkLogic Task
Option for Appointments interface also must be set if using this feature – Document Creation button.)
8)Click OK
Note for Customers of Centricity Physician Office Practice Management:
Books in Centricity EMR are equivalent to Resources in Centricity Physician Office
Practice Management system
20
Slot Sizes
If you have another practice management or scheduling system and use
ScheduLink Import to transfer appointment information to Centricity EMR, you don’t
need to set up specific appointment slot sizes — they already exist in the other
system.
It is recommended to leave all these checked.
21
Templates
If you have another practice management or scheduling system and use
ScheduLink Import to transfer appointment information to Centricity EMR, you don’t
need to set up appointment templates — they already exist in the other system.
22
Types
Types correspond to the appointment types in the practice management
system. Appointment types need to be created at the top of the hierarchy
because they are shared across all locations of care.
To Create an Appointment Type:
1) Highlight the top level of the location of care hierarchy.
2) Click the New button to create the Appointment Type.
3) For Name, enter a name that identifies this appointment type. (needs to be
unique with no punctuation) Centricity EMR users see appointment types when
viewing appointments in appointment books.
4) For Default Urgency, select the usual level of urgency for appointments of this
type. You can change the urgency when scheduling an appointment.
5) For Overbook, select whether to allow other appointments at the same time
(overbook) as this appointment type.
6) For Search Range, enter the number of days to search ahead when searching
for available slots for this appointment type. A search range of one day means
that only today’s or tomorrow’s date is acceptable; a range of zero days limits
the search to today’s date.
Continued on next page……..
23
Types (continued)
……Continued from previous page
To Create an Appointment Type (cont’d.)
For Default Duration, enter the number of minutes usually allowed for appointments
of this type. You can change the default duration when scheduling an appointment.
7) For Location of Care, ensure that the top location of care in the hierarchy is
selected, since appointment types are shared across all locations of care.
8) For Patient Instructions, enter any instructions (such as no food after midnight) to
give to the patient before this type of appointment. You can change the instructions
when scheduling an appointment.
9) For Linked Books, select two or more appointment books that should be
scheduled (for example the provider’s and EKG equipment appointment books) if
appointments of this type should also be scheduled in multiple appointment books.
10)For Encounter Type for Document Creation, select an encounter type that
defines document properties and components to use for this type of appointment. If
you select <None>, this type of appointment does not automatically cause Centricity
EMR to begin a chart update when a patient is arrived and does not create any
chart documents.
11)Click OK.
24
Lesson 4: Chart Folder
•Chart Folder
•Coding Requirements
•Discuss Using Uncoded Clinical List Items
•Add New or Edit Orientation of Document Views
•Add New or Edit and Orientation of Flowsheet Views
•Add New or Edit Orientation of Flowsheet Custom Labels
•Formulary Management
•Join Updates
•Add New or Edit Allergy Custom Lists
•Add New or Edit Medication Custom Lists
•Add New or Edit and Orientation of Patient Banner
•Add New or Edit Problem Custom List
•Add New or Edit Problem List Views
•Add New or Edit Protocols
•Add New or Edit Quick Text
25
Chart Folder
To Access the Chart Folder:
1) Go to Go>Setup>Settings>Chart folder
2) Expand the Chart folder (alphabetical order) by clicking the “+” sign next to the
Yellow Chart Folder
•
Patient Banner
•
Quick Text
•
Document Views
•
Flowsheet Views
•
Coding Requirements
•
Join Updates
•
Problem Custom Lists
•
Medication Custom Lists
•
Protocols
•
Formulary Management
26
Coding Requirements
Centricity EMR lets you decide whether users can enter uncoded problems
and whether to mark uncoded problems, medications, and allergies with an
asterisk.
Best Practice:
1) Uncheck “Allow uncoded problems” and require all problems to be coded.
2) To precede uncoded problems, medications, and allergies with an asterisk (*)on
the Chart Summary, Problems, Medications, and Alerts tabs, on the Chart
Summary report, and on the output of any referenced data symbols, check “Show
uncoded problems, medications, and allergies with asterisks.”
Check “Show previously selected potential diagnoses with shaded background”
if this is the behavior desired when ordering items via the Orders module.
Note: If you have multiple locations of care, note that all clinics share the same
clinical content. Any coding requirement put in place for one location of care
affects all locations.
27
About Uncoded Problems,
Medications, & Allergies
Uncoded
Problems and
Medications
denoted with
asterisk (*)
Uncoded Problems----Problems selected without using ICD or CPT coding schema are considered
uncoded.
•If you decide to allow uncoded problems, providers can enter problem descriptions into a chart without an
associated code.
•If you decide to not allow uncoded problems, only problems with a valid ICD or CPT code may be added
to the patient’s problem list in the chart.
•Problems must be entered using a custom problem list or reference list search.
•You can decide whether to display an asterisk (*) in front of uncoded problems. This decision applies
across the entire database.
Uncoded Medications----Medications that do not match entries in the medication reference list are
considered uncoded. In addition, if you select a medication from a custom list or reference list and edit its
description, Centricity EMR treats it as an uncoded medication.
•Uncoded medications are not included in interaction checking, but you will be notified that the medication
is not being checked for interactions or prior adverse reactions.
•You can decide whether to display an asterisk (*) in front of uncoded medications. This decision applies
Coded allergies---specific medications chosen from the medication reference list.
Uncoded allergies----general descriptions not on a medication reference list; for example, cats, bee sting,
or eggs.
•If an allergen, such as a bee sting, is not on a medication reference list, the allergy is entered as uncoded.
As with medications, uncoded allergies are not included in interaction checking, but you will be notified that
the allergy is not being checked for interactions or prior adverse reactions.
•You also can decide whether to display an asterisk (*) in front of uncoded allergies. This decision applies
28
Document Views
Document Views are used to filter
documents to view. Document
views can be set to filter based on 4
properties:
1) Document type
2) Document location
3) Document confidentiality type
4) Document status
To Create a Document View:
1) Select the <Global List> or a specific user for which to create the view.
2) Click New and the New Document View window opens
3) For View name, enter a unique name for the document view
4) For Document types, select the document types to include in the view. Note: A
document type is a property, like a label, that describes the kind of information contained in
a document. There are both internal document types and external report types.
5) For Locations, select one or more document location(s) of care.
6) For Confidentiality type, select one or more sensitivity classification(s) (such as Normal
and AIDs).
7) For status, do one or more of the following:
•To include documents one or more staff are actively updating, select In Progress.
•To include documents with chart notes that have not yet been signed nor are in Progress,
select On Hold.
•To include documents that are neither signed nor on hold, select Unsigned. These are
typically external reports imported through LinkLogic or internal documents, such as letters
or handouts, that are not created as part of the chart update.
•To include documents that are permanent parts of the patient chart, select Signed.
8) Click OK and the document view is created.
29
Document Views
Once the document
view is part of the
user’s preferences,
we can see the
“Office Visits”
Document View
Once the document view is associated with the user’s chart documents preference,
the new document view can be used for filtering / finding documents.
Note: Document views can also be created by users via the organize button
located on the documents tab.
Additional privileges are required to create global views. Global views created can
easily be associated with all users in the enterprise via Preferences Setup.
(Set Preferences in GO>SETUP>PREFERENCES>CHART>DOCUMENTS)
30
Flowsheet Views
Looking at an example of a CBC
flowsheet view from Walter
Caldwell’s chart.
A flowsheet view is a collection of observation terms that you want to see grouped
together in a the flowsheet tab of a patient’s chart. The observations list in the EMR
application contains hundreds of items. The flowsheet views are a grouping mechanism
that lets you display and examine a subset of observations. They are similar to lab
panels in that they make it easy for you to see related results as a group. With flowsheet
views, you can group observations that are relevant to a particular clinical specialty,
problem, or type of patient.
Here’s an example of the CBC flowsheet in Walter Caldwell’s chart.
31
Flowsheet Views
To Create
Flowsheets in
respective folder
To Create
the folder
Structure
for flowsheets
The flowsheet views area of setup allows creation of the folder structure for
flowsheets (middle pane) and setup of flowsheets (far right pane).
To Set Up the Folder Structure for Flowsheets:
1) Highlight the folder in which to create the new folder
2) Click New and enter the name of the folder.
3) Click OK to save the folder name
32
Flowsheet Views: Creating Them
Find Observation Term Window
To Create a Flowsheet View:
1) Select the folder that will contain the flowsheet view
2) Under “Flowsheet Views in”, click New and the New Flowsheet View window
opens
3) For Flowsheet View Name, enter a unique intuitive name for the flowsheet view.
4) For Included observation terms, do the following:
•
Click the binoculars
•
The Find Observation Terms window opens (Note: This window is
expandable.)
•
Browse or Search for an observation term to use in the flowsheet view.
•
Double-click an observation term to select it.
•
The observation term is included in the list in the New Flowsheet View
window. Don’t worry about the sequence in which you select the
observation terms. You can sort them in the next step.
Continued on next page…….
33
Flowsheet Views: Creating Them
…….Continued from previous page
To Create a Flowsheet View (cont’d.):
5) To sort the observation terms into the order in which you want them to appear in the flowsheet,
do the following:
•
Select an observation term. **Tip: To move a group of contiguous terms, press Shift
then click the first and last term in the list.
•
Click the upwards arrow or the downwards arrow to move the term(s) up or down in the
list, or “drag & drop” the obs term(s) where needed.
•
Click the red “X” to remove the selected observation term
6) For Date Resolution, select a default time scale. If you have a flowsheet of observations that
typically occur once a year, select Years. If you have a flowsheet of observations, such as
cultures, that always occur in hour increments and you want to show all observations available,
select Hours. The default date resolution is Days.
7) Click OK and the flowsheet view is created.
Note: Downloading the most current set of observation terms from the Support web site is
recommended to ensure the most up-to-date observation terms are available. Observation terms
are updated monthly and should be downloaded and imported into your database regularly.
34
Flowsheet View Custom Labels
Flowsheet View Setup will allow you to create Custom Labels for Observation Terms to
make them more user-friendly.
You can create custom flowsheet labels with up to 256 case-sensitive characters.
The names are visible when graphing and also in the update flowsheet dialog box. You
can have several different names for the same observation term and use in different
flowsheets. You can also designate custom label names for specific observation terms
when appearing in the “ALL” view.
Only users with specific privileges have the ability to create custom flowsheet labels.
Note: These are label names only; you cannot create your own observation terms. If you
need custom observation terms, these must be requested from Support. A kit can be
downloaded from the KnowledgeBank to help you with your request.
Lab results which import using Linklogic do not support custom flowsheet labels.
Actual observation term names must also be used in reports.
Continued on next page…….
35
Flowsheet View Custom Labels
…..Continued from previous page
To Create Custom Labels:
1) Go to Go>Setup>Settings>Chart>Flowsheet Views
2) If the flowsheet already exists, locate & highlight the flowsheet and click CHANGE.
3) When the CHANGE FLOWSHEET VIEW window opens, you can free text into the
CUSTOM LABEL field or right-click on the description for the obs term & copy to the label.
4) Click OK to save
Typically, any custom labels created should also be replicated to the All View. Click the
All View button to add all observations with their corresponding custom label names to
ensure consistency when viewing the flowsheet.
36
View with Custom Label
Looking at an example of a CBC
flowsheet view with Custom Label in
Walter Caldwell’s chart.
Once a custom label has been created in a flowsheet view, it is visible in the
flowsheet tab of the patient’s chart when that view is selected.
37
History Views
History Views can be created to include specific observation values from the
flowsheet in a tabular layout in the chart History tab. Tables are created via
Microsoft Word, which are then copied & pasted into History Views setup.
CEMR 9.0 comes with 3 standard views:
•
System History
•
Patient History (Separate Clinical Kit)
•
Immunization History (Separate Clinical Kit)
To Set Up the Folder Structure for History Views:
1) Highlight the folder in which to create the new folder
2) Click New and enter the name of the folder
3) Click OK to save the folder name
38
History Views: Creating Them
To Create a History View:
1) Select the folder that will contain the history view.
2) Under “History Views in”, click New and the New History View window opens
3) For History View Name, enter a unique name for the history view.
4) Go to Microsoft Word and create a table using Word functions.
5) Copy and paste the table into your history view window.
6) Click the Insert Symbol button to incorporate data symbols. Refer to Symbols Help for
additional information on data symbols you wish to use.
7) For Included observation terms, do the following:
•
Click insert observation term
•
The Find Observation Terms window opens (Note: This window is expandable.)
•
Browse or Search for an observation term to use in the history view.
•
Double-click an observation term to select it.
•
The observation term is included in the list in the New History View window.
•
Continue to add terms until you complete your History View
•
Click OK to save.
Note: History Views can be exported/imported as a clinical kit.
39
About Formularies:
A formulary is a list of medications that an insurance company has determined to be
most cost-effective for a given therapeutic use. You can associate a formulary with an
insurance plan. Only one formulary can be associated with an insurance plan.
Importing InfoScan formularies:
If your Practice has purchased the InfoScan formularies, these can be downloaded
from Support, using your site’s user ID & password. The URL for the Support web site
is: http://support.medicalogic.com
Once the formularies have been downloaded & imported into the EMR, they will be
seen in the Formulary Management area of Setup. Here, you can associate the
downloaded formularies with an insurance type and plan.
You need to review the list of available formularies from InfoScan. You may need to
contact the insurers to clarify which formulary applies to which product or plan.
Also note that new and updated formularies are distributed along with regular updated
medication lists.
40
To Import Formularies: (after downloading & extracting)
1) Navigate to Go>Setup>Settings
2) Expand the System folder and highlight Import Clinical Kits.
3) Click the Import Clinical Kit button.
4) Navigate to the location where the formularies were downloaded.
5) Find & select the file(s) with the .ckt extension.
6) The clinical kit will download to the database.
To Add Formularies For an Insurance Plan:
1) Go to Go>Setup > Settings>Chart>Formulary Management.
2) Select a formulary in the list.
3) Click Details to review information about the formulary.
4) To associate the formulary with an insurance plan, click Associate.
5) In the Insurance Company list, select an insurance company. Tip: To filter the list of insurance
companies, use the Search option.
6) In the Plan list, select the insurance plan that you want to associate with this formulary.
7) Click OK.
8) To set up a formulary as the default for your enterprise, select the formulary then click Set
Formulary as Default.
Note: If you decide to have one default formulary for all patients and have multiple locations of care, all clinics
on the database must share the same default formulary.
41
Join Updates
During a patient encounter, a provider updates a chart and creates documents that
are then marked as In Progress or On Hold. When another provider decides to
contribute information to the same episode of care, the provider is asked whether to
join the ongoing update or start a new update.
During setup, you have the option to restrict users from updating a chart if they are
not authorized at your location of care. In this case, providers not authorized at your
location of care must start a new update or append to a signed document
42
Allergy Custom Lists
When adding a
new substance
to the custom
list, you can
classify it as a
drug, food or
environmental
allergen.
The easiest way to find allergies when updating a chart is to use allergy custom lists. Allergy
custom lists can contain medications, foods, or environmental allergens that represent the
allergies most frequently encountered at your clinic.
Providers can add to the list of patient allergies or adverse reactions using the New Allergy or
Adverse Reactions window. If custom lists are used, providers can type a few matching
characters to select from a shorter allergy custom list instead of searching through the whole
Medication reference list. The allergen classification further identifies the type of allergy or
adverse reaction: drug, food, or environmental allergen.
You can create your own allergy custom lists.
To Create Allergy Custom Lists:
1) Go to Go>Setup>Settings>Chart>Allergy Custom Lists
2) Select NEW and give the list a custom name
3) Select NEW in the substance dialog box and search for the desired substance.*
4) Classify the substance as food, drug, or environment
5) Click OK to save
*Note: If allergy is food or environmental, click NEW, then click the CANCEL button, & type in
the name of the allergy in the Substance Name field.
43
Medication Custom List
To Create a New Medication Custom List:
1) Click the new button at the top of screen to create a new medication custom list.
2) Type the name of the medication custom list.
3) Click OK.
To Add Medications to the Custom List:
1) Highlight the name of the medication custom list in which you need to add
medications.
2) Click the New button on the lower portion of the screen to add a medication to
the custom list.
3) Search for the name of the medication.
4) Highlight the medication name to add to the custom list.
5) Click OK
Note: If your Practice is utilizing the CCC content, you may add items to any of the
custom lists but do not change the names of the custom lists.
44
Adding Custom Medications
When adding a medication to the custom list, Centricity EMR also allows you to
save Optional Fields to the custom list entry.
To Add Optional Information:
1) For Instructions, type the medication’s default instructions
2) Select the duration in days, weeks, or months.
3) Select the quantity and refills.
4) Select “Brand medically necessary”, if applicable.
5) Click the OK button to save the medication custom list entry.
45
Patient Banner
An example of
the “Patient
Banner with
Protocol Alert”
Patient Banners are seen when accessing a chart or the patient’s registration
screen.
Patient banners can be set according to individual, group, or Enterprise
preference.
(Go>Setup>Preferences>Chart>Patient Banner)
Note: Banners for active patients display in blue. All factory banners for
inactive, deceased, or obsolete patients automatically display in red; you
cannot change that color.
46
Patient Banner
To Add Patient Banners:
1) Click New.
2) The Patient Banner window opens.
3) For Name, enter a unique name to identify the patient banner. If you have multiple
locations of care, consider using a prefix that indicates the location of care.
4) Add static text as necessary.
5) To format the text and check spelling, use the Edit toolbar.
6) To use a data symbol to insert information specific to a particular patient, document, user,
or location of care, do the following:
• Place your cursor in the text area where you want to insert the data symbol.
• Click Insert Symbol and the Insert Symbol window opens.
• To find a data symbol to insert, enter all or part of a symbol name, then click Find.
• Select the data symbol. (Refer to Symbol Help as needed.)
• Click OK to return to the Patient Banner window.
7) Click OK. The patient banner is added.
Note: It is recommended that patient banners initially be built in Network Training. To view
changes made to the banner, it will be necessary to switch patient charts to refresh the
screen and pull in the updates. After the banner has been built to your satisfaction, it can be
exported from Network Training and imported into your production database.
47
Problem Custom Lists
The easiest way to find problems when updating a chart is to use problem custom lists. Problem
custom lists are subsets of ICD and CPT codes that represent the problems most frequently
encountered at your clinic.
To Create a New Problem Custom List:
1) Click the new button at the top of the screen to create a new problem custom list.
2) Type the name of the problem custom list.
3) Click OK.
To Add Problems to the Custom List:
1) Highlight the name of the problem custom list in which you need to add problems.
2) If adding an ICD-9 code, leave the radio button at Diagnosis.
3) Click the New button on the lower portion of the screen to add a problem to the custom list.
4) Search for the name of or code for the problem.
5) Highlight the problem name to add to the custom list.
6) Change the problem description to Clinician-friendly terminology as desired.
7) If the problem should drop off of a patient’s active list after a specified time, enter a duration. The
EMR application uses your entered duration to determine the problem’s end date. (Note: This field
defaults to zero (0) – disabled.)
8) Click OK.
Note: If your Practice is utilizing the CCC content, you may add items to any of the custom lists but do not
change the names of the custom lists.
48
Problem List Views
Problem list views enable clinicians to organize patient problems in a meaningful
way and to share that organization with other clinicians. Problem list views can be
assigned as a preference so that like-minded clinicians can share the same view.
The preference is merely a name indicating the view, such as cardiology view or
dermatology view.
(Set preference for individual users, groups, or the Enterprise in Go>Setup>
Preferences>Chart>Problem List View)
49
Protocols
To Create
protocols in
respective folder
To Create
the folder
Structure
for protocols
Centricity EMR supports preventive care by letting you set up protocols. These
protocols can alert you when a patient is due for a particular action, based on factors
that include sex, age, current problems, and current medications.
The protocols are sets of rules that define what tests and interventions are
appropriate, and at what age or intervals they should be performed.
You can use the protocols that come with CEMR 9.0, or you can create your own
custom protocols. You can also copy the application’s protocols and make any
changes you need. You are responsible for confirming all protocols, even those
provided with CEMR, are consistent with your clinical guidelines and requirements.
Creating protocols may take some trial and error. Plan to develop your protocols in the
Single-User Training Database or Network Training, so you can test them on sample
patients before you use them with your real patient population.
To Set Up the Folder Structure for Protocols:
1) Highlight the folder in which to create the new folder.
2) Click New and enter the name of the folder.
3) Click OK to save the folder name.
50
Protocols: Summary Tab
To Create a New Protocol – Summary Tab:
1) Click the New button.
2) Enter a unique name describing the protocol in the name field of the summary
tab.
Note: The details for population and events will display when completed in
respective tabs.
51
Protocols: Population Tab
To Specify Patient Sex, Age, and Keywords – Population Tab:
1) For Patient Sex, select Male, or Female. To select both Male and Female, select
Unspecified.
2) For Patient Age is Between, enter an age range in months and/or years. The default is
0 months and 140 years.
3) To enter registration note keywords, such as "Clinical trial 144" or "Eastside Pediatrics"
and "Westside Pediatrics," select Keyword and click New. Enter the keyword and click
OK.
9 The protocol description displays on both the Population and Summary tabs when
completed.
52
Population Tab - Problems
To Specify Problems – Population Tab:
1) Select Problems and click New.
2) Select a problem type, such as Problem Of, Diagnosis Of, Status Post, or Symptom
Of.
•
If you choose Diagnosis of, the EMR application will use whatever default
duration is set up in the custom list entry to determine the end date.
•
If you choose Self-limiting problem, the protocol catches all “diagnosis of”
problems with an end date.
3) To enter the description or code associated with the problem type, do the following:
•
To associate a problem description with the problem type, select “Search
description for String Match”; then enter the problem description in the text box
and click OK.
•
To enter an ICD code, select Search for matching code and enter the ICD code
for a problem. To search the problem reference list for the code, click
Reference List and find the ICD code.
9 The protocol description displays on both the Population and Summary tabs when
completed.
53
Population Tab - Medications
To Specify Medications – Population Tab:
1) To enter a medication, select Medications and click New.
2) Do the following:
•
Select Search Description for String Match and then enter a medication
name.
•
To search for a medication, select one of the following search criteria:
Search Description for String Match, Search for Matching Code, Search
for Equivalent Medication, or Search for Medication Classification. Click
Reference List and search for the medication.
9 The protocol description displays on both the Population and Summary tabs
when completed.
54
Population Tab - Observations
To Specify Observations – Population Tab:
1) To enter a flowsheet observation, such as BP Systolic greater than 220, select
Observations and click New.
2) Make the following selections:
•
Click the binoculars to search for and select an observation term.
•
For Where, select a condition and enter a value for the observation.
•
For During The, select a time period for the observation.
3) Click OK.
9 The protocol description displays on both the Population and Summary tabs
when completed.
55
Protocols: Events tab
The events tab allows selection of specific observation terms that will be tracked
by the protocol.
To Add Observations to Be Tracked With the Protocol:
1) On the Events tab, click New.
2) For Observation, click the binoculars icon to select an observation term, such as an
immunization, exam, or test, that is needed at certain intervals. Repeat as needed.
3) For Due Date, enter information that identifies how often the immunization, exam, or
test should be performed.
4) For +/- %, enter the percentage variance for events. This is the amount of time the
application allows for the test to appear as due. For example, a cholesterol screen
probably doesn't have to take place on the same day every five years. If the test date
can vary a month in either direction, enter +/–2% (two percent of five years is about a
month).
5) Add comments as necessary.
6) Click OK. The protocol description displays on both the Event and Summary tabs.
56
Quick Text
Quick text is a shortcut tool that lets you insert common phrases, form
components, text components, and data symbols into a chart note just by typing a
few characters.
For example, when you type ".wnl" during a chart update, Centricity EMR inserts the
phrase "Within Normal Limits" and when you type ".med" the patient's current list of
medications is inserted. Similarly, you can insert a form component by typing the
quick text ".fc".
Quick text can be global (shared by all users) or user-specific—each user at a clinic
can share a common core of quick text and also can define his or her own personal
list of quick text shortcuts. If the same quick text abbreviation is used on both the
individual list and the global list, the quick text on the individual list overrides the
quick text on the global list for that user. For example, the global quick text for .cp is
"Patient presents with chest pain." If you create your own quick text for .cp that
translates to "Patient presents with cardio-pulmonary complications“, when you type
.cp you get your version. When all other users type .cp, they get the global version.
57
Creating Quick Text
To Create Quick Text:
1) Select a specific user or the Global List (which will be available to all users).
2) The Define Quick Text window displays.
3) For Replace, enter a period (.) followed by the quick text abbreviation. (It is
recommended to begin each abbreviation with a period symbol to differentiate
quick text from regular abbreviations.)
4) For With, enter the text that will replace the abbreviated quick text.
5) Click Add.
To Insert Data Symbols as Part of the Text Replacement:
1) Place the cursor at a point of insertion in the With field.
2) Select Insert Symbol.
3) The Insert Symbol window opens.
4) Select the data symbol. (Refer to Symbol Help as needed.).
5) Click OK.
Note: Individual users can create their own library of quick text via the Options menu.
(Options>Quick Text)
58
Information regarding Quick Text
• Quick Text does not support Rich Text Formatting (RTF), i.e. bold, italics, etc.
• You can embed carriage returns in Quick Text.
• You can use MedicaLogic Expression Language (MEL) in Quick Text.
• Currently, Quick Text does not work in the following areas: Appointment reason, Flag
subject, Routing comments, Summary line in an Update, Single-line edit field in a form
component, Handouts & Letter Templates in Setup.
• The maximum number of characters in a Quick Text entry is 512.
• If more characters are needed, and can be accommodated in the field, you can create
a Text Component and then create a Quick Text to insert that text.
Use the following syntax and parameters:
{INSERT_TEXT_COMP(“folder path”, “text component name”)}
• For example, to insert the Physical Exam text component, define quick text as:
{INSERT_TEXT_COMP(“Enterprise\MedicaLogic\Exam”, “Physical Exam”)}
• If you receive error messages, double check that you are using double quotes and not
two single quotes.
• You can insert form components the same way using
{INSERT_FORM_COMP("folder path", "form component name")}
59
Prescription Requirements:
Configure Biometric Authentication
Biometric Authentication is a new feature that helps verify a user biometrically when
faxing prescriptions to a pharmacy and when signing/holding a document.
To use Biometric Authentication, you must connect the APC Touch Biometric POD
Password Manager to your workstation. You need to complete the Biometric configuration
and registration to use it.
Complete the Following Steps to Configure Biometric Authentication:
1) Go to Go>Setup>Settings>Chart>Prescription Requirement
2) The Prescription Requirement window opens. The left pane lists all states and the right
pane displays states where you will require Biometric authentication to fax a prescription
from your system.
3) To add a state to the list of states that need Biometric Authentication, select a state
from the left pane and click Add.
4) To remove a state from the list of states that need Biometric authentication, select a
state from the right pane and click Remove.
5) To add all the states to the list of states that need Biometric Authentication, click Add
All.
6) To remove all the states from the list of states that need Biometric Authentication, click
Remove All.
60
Prescription Requirements:
Biometric Registration
To Register Your Fingerprints for Biometric Authentication:
1) From the Options menu, select Authentication>Biometric Registration. The Biometric
Login window appears.
2) Enter the User ID and Password. (To ensure security of the application, a user with
administrative privileges is required to enter their user name and password on the first
“Biometric Registration” page.)
3) Click Next. The “Choose a Finger” window appears.
4) Select the finger you want to register by clicking over the finger. If you select a finger
that is already registered, the following message displays: “This finger is already
registered. Do you want to delete this?”
5) Register the selected finger by gently placing your finger on the biometric device. You
have to repeat this five times. After registering a finger successfully, you can register other
fingers. For enhanced security, the users’ actual fingerprint is never stored.
GE recommends that you register at least 2 fingers to ensure that you can authorize
prescriptions biometrically when you cannot use your preferred finger (when gloved or
injured). When you register your fingerprint using Biometric, register the least used finger
of the least used hand as one of the biometrically registered fingers.
61
Lesson 5: Chart Documents
Folder
•Chart Documents Folder
•Create New or Edit Margins
•Edit Headers
•Discuss Foundation for Creating Documents
•Add Form Components
•Create New or Edit Text Components
•Create New or Edit Document Templates
•Create New or Edit Encounter Types
•Edit Settings for Image Attachments
62
Chart Documents Folder
To Access the Chart Documents Folder:
1) Go to Go>Setup>Settings>Chart Documents folder
2) Expand the Chart Documents folder (alphabetical order) by clicking the “+” sign
next to the Yellow Chart Documents Folder
•
Margins
•
Header
•
Form Components
•
Text Components
•
Document Templates
•
Encounter Types
•
Image Attachments
63
Margins
To Set Margins for Chart Documents:
1) Click on Margins. The margin settings will display on the right.
2) Click the Change Button
3) The Change Margins window appears. Enter the margins for Left, Right, Top, &
Bottom in inches.
4) Click OK to save.
Margins for all chart documents are now set up.
64
Header
Many Practices use the standard header, but this can be customized utilizing static
text and/or data symbols.
To Change the Chart Document Header:
1) Click Change Chart Document Header. The Change Header window displays. Chart
Document displays as the name.
2) Add, overwrite, delete, or change text as necessary. To format the header text and
check spelling, use the Edit toolbar.
3) To use a data symbol to insert information specific to a particular patient, document,
user, or location of care, do the following:
•
Place your cursor in the text area where you want to insert the data symbol.
•
Click Insert Symbol. The Insert Symbol window opens.
•
To find a data symbol to insert, enter all or part of a symbol name, then click
Find.
•
Select the data symbol.(Refer to Symbol Help as needed.)
•
Click OK. You return to the Change Header window.
4) To add page numbers, place your cursor in the text area where you want to insert the
page number. Click Insert Page Number.
5) Click OK to create the header.
65
Header Shading
It may be necessary to adjust the amount of shading that appears in the header of
printed documents - for example, when documents are faxed and the shaded area is not
readable.
To Change the Shading on Headers:
1) Left click on the 1st line of shading.
2) Right click on the selected line.
3) Select Tabs.
4) Select Border/Shading…
5) Adjust the Shading percentage and click OK.
6) Repeat the process for the 2nd shaded line.
66
Foundations for
Creating Documents
Encounter
Types
Document
Templates
Form & Text Components
Document Templates allow us to setup necessary elements for documents by
mixing and matching Form Components, Text Components and static text. The
system allows the user to decide what components to use and in what order to
place the components.
Encounter Types launch the specified Document Templates, containing the Form
Components and/or Text Components.
67
Form Components
Form Components
in their
respective folder
To Create
the folder
Structure
for form
components
A form component is a collection of items, such as check boxes, drop-down lists,
and text boxes, that are grouped together to create a data entry tool that makes it
easy to quickly record observations and other patient information during a chart
update. Form components let you combine the flexibility of text notes with the
structured data of the clinical lists. Information you enter in a form can be saved as
an observation or as text. Form components are also known as encounter forms.
In the center of the screen:
•The folder structure is identified where the forms are located. Note: The folder
structure for form components is shared with text components.
On the far right of the screen:
•The Names of the forms that live in the respective folder are seen.
•Double-click on the form name to see description, version, date created, and
author of the form.
NOTE: Form Components are not created in this section of Centricity EMR, this is
simply where the folder structure for the forms is located. To setup or modify forms,
use the Encounter Form Editor software.
68
Text Components
Create text
Components
To Create
the folder
Structure
for text
components
Text Components are pieces of reusable text that make it easy to capture
information into a chart note for standard types of patient encounters—they let you
use and customize the same basic note text in many updates.
•The folder structure is identified where the Text Components are located. Note: The
folder structure for text components is shared with form components.
•The names of the Text Components that live in the respective folder are seen.
Text Components can include straight text and/or data symbols that evaluate either
when inserted or continuously.
TIP: If you have a quick text item greater than 512 characters, set it up as a text
component.
69
Creating a Text Component
To Create a Text Component:
1)
2)
3)
4)
5)
Select the folder that should contain the text component.
Under “Text Components in” area, click New.
The Text Component window opens.
For Name, enter the text component name.
Enter static text or other elements you want to include in the text component, such as
note headings and lead-ins to bulleted lists.
6) To use one or more data symbols that quickly add information into the chart note, do the
following:
• Place your cursor in the text area where you want to insert the data symbol.
• Click Insert Symbol and the Insert Symbol window opens
• To have the data symbol evaluated when it is inserted, click When Inserted in
Note. The value the of the data symbol at the instant it is inserted will no longer
change. Select this option for information such as name, address, and insurance
information that seldom changes during chart updates.
• To have the data symbol be updated during a chart update, click Continuously. The
symbol is inserted in the note but is red in color to note that it can be updated. If the
data for the symbol changes, the chart note is updated up until the time the chart
document is signed. Select this for information that may change while an update is
in progress, and for which you always want to see the latest value.
• Click OK to return to the Text Component window.
7) Click OK and the text component is added.
70
Document Templates
Create Document
Templates
To Create
the folder
Structure
for Document
Templates
Document templates allow us to setup necessary elements for documents by mixing and matching
form components, text components, and static text. The system allows the user to decide what
components to use and in what order to place the components.
• The folder structure is identified where the Document Templates are located.
• The Names of the Document Templates that live in the respective folder are seen.
71
Creating Document Templates
To Create a Document Template:
1) Select the folder that should contain the document template.
2) Under “Document templates in”, click New and the Document template window opens.
3) For Name, enter the document template name.
4) Enter static text or other elements you want to include in documents using this template.
5) To insert form component(s), do the following:
•
Place your cursor in the text area where you want to insert the form component(s).
•
Click Insert Form Component and the Find Form Components window opens.
•
Click the Browse or Search tab to find the form component(s) you need.
•
Select one or more form components from a single folder and then click OK.
6) You return to the Document Template window and the template is updated.
7) To insert text component(s), follow the same steps as above, except :
•
Click Insert Text Component and The Find Text Components window opens.
8) Click OK and the document template is created.
72
Encounter Types
An Encounter Type launches a specific Document Template, containing the Form
Components and/or Text Components needed for the visit. Note: Before you can build
encounter types, document templates must be created.
To Create an Encounter Type:
1) Click the New button and the New Encounter Type window opens.
2) For name, type a unique encounter type name.
3) For document type, select the document type from the drop-down that you wish to use for
the encounter.
4) For confidentiality type, select the default confidentiality type.
5) For document template, link the appropriate document template:
• Click the ellipsis (…) button
• Search the folder structure for the appropriate document template and click OK
6) Optional: For document summary, type a default document summary that will be seen
when beginning an update.
For Open First Form, select one of the following options:
•To have the first form of the template not automatically open when the chart update is started,
select Never.
•To have the first form open the first time the chart update is started, select First Time Only.
•To have the first form open automatically every time a chart update is started or an on-hold
document using that template is opened, select Every Time.
73
Image Attachments
To minimize the space required, you can set a size limit for images stored in the
EMR database. When an attached image exceeds this limit, the user can edit the
image to reduce its size or re-attach the image at a lower resolution from the device.
74
Lesson 6: Desktop Folder
•Desktop Folder
•Create New or Edit Document Views
75
Desktop Folder
You can create global or personal Desktop Document Views to filter desktop
documents using specific criteria. When used with desktop groups, you can display
similar documents for multiple users on the desktop.
To Access the Desktop Folder:
1) Go to Go>Setup>Settings>Desktop folder
2) Expand the Desktop folder (alphabetical order) by clicking the “+” sign next to the
Yellow Desktop Folder
3) Settings for Document Views appear.
76
Create Desktop Document Views
To Create Desktop Document Views:
1) Select <Global List> or a specific user from the drop-down list.
2) To create a new Desktop document view, click New.
3) For View name, enter a unique name for the document view that describes the
group of documents that will be displayed - for example, Lab reports or Filed in
Error. This name appears as a folder in the top-left corner of the Desktop
Documents tab. It also displays on the Desktop Summary tab in the Documents
section, where you can click to list the views.
4) Select the Document Types, Priorities, Locations of Care, Confidentiality Types,
and Statuses that you want to include in the Document View. (If users do not have
confidential document privileges, they cannot access confidential documents even if
they are selected for their document view.)
5) Click the More.. button further sorting options.
Note: Preferred Desktop Document Views are associated to individual users,
groups, or the Enterprise in Preferences. (Go>Setup>Preferences>Desktop>
Documents)
77
Lesson 7: Handouts Folder
•Handouts Folder
•Edit Margins
•Edit Headers
•Create New or Edit Handout Templates
•Create New or Edit Custom Lists
•Setup Illustrations Location Path
78
Handouts Folder
In set-up you will need to access the Handouts Folder for changing handout
Margins & headings, and creating handout templates. You can also create
handout custom lists and specify your Practice’s handout illustrations location.
To Access the Handouts Folder:
1) Go to Go>Setup>Settings
2) Expand the Handouts folder (alphabetical order) by clicking the “+” sign next to
the Yellow Handouts Folder
• Margins
• Header
• Handout Templates
• Custom Lists
• Illustrations Location
79
Margins
To Set up Margins for Handouts:
1) Click on Margins. In the right hand side of the screen the margin settings will
display.
2) Click the Change Button. The Change Margins window appears.
3) Enter the margins for Left, Right, Top, Bottom in inches.
4) Click on OK to save the margins.
Margins for all handouts are now set up.
80
Header
Edit Toolbar for formatting
and spell check
To Set Up Headers For Handouts:
1) Go to Go>Setup>Settings>Handouts>Header.
2) Select Change Handout Header. The Change Header window opens.
3) Add, overwrite, delete, or change text as necessary. To remove a data symbol,
overwrite or delete its definition.
4) To format the header text and check spelling, use the Edit toolbar.
5) To add page numbers:
•
Place your cursor in the text area where you want to insert the page
number.
•
Click Insert Page Number. The page number symbol is inserted.
6) To use a data symbol to insert information specific to a particular patient,
document, user, or location of care:
•
Place your cursor in the text area where you want to insert the data
symbol.
•
•
To find a data symbol to insert, enter all or part of a symbol name, then
click Find.
•
Select the data symbol. (Refer to Symbol Help as needed.)
•
7) Click OK. The header is created.
81
Handout Templates
Handout templates will allow clinics to enter their own custom handouts within
Centricity EMR. The folder structure for the handouts is located in the middle pane.
To Add a Handout Template:
1) Highlight the folder that the template will reside in.
2) Click the New button and the Handout window opens.
3) For name, give the handout a unique name.
4) Type straight text or insert data symbols which will pull patient data from the system.
(Refer to Symbol Help as needed.)
TIP: If trying to create tables or format the handout, use Microsoft Word, which will
allow for more editing.
82
Custom Lists
To help narrow down the list of handouts when first setting up the EMR application,
it helps to create a set of Handout Custom Lists. Each handout custom list will be
available for the entire database.
To Create a Handout Custom List:
1) Enter the name for the handout custom list by clicking the New button at the top
of the screen.
2) Add handouts to the custom list by clicking the New button in the lower portion of
the screen. The find handouts window displays.
3) Search or select the handout and click OK
Note: Users can create their own custom list of handouts “on the fly” inside the
EMR application.
83
Illustrations Location
Handouts sometimes have corresponding illustrations that you can print for patients.
The application stores and accesses these handout illustrations in GIF format on
your server.
At this time, you cannot add illustrations to handouts you create.
To set up an absolute path where the illustrations files are located on the server,
select the browse button to navigate to and associate the proper path.
NOTE: An absolute path is the exact server location, not a mapped drive.
Individual user, group, or enterprise preferences to access handout illustrations
from the server vs. local workstations can be set in Preferences.
(Go>Setup>Preferences>Handouts>Illustrations Location)
84
Lesson 8: Letters Folder
•Letters Folder
•Edit Margins
•Edit Headers
•Create New or Edit Letter Templates
85
Letters Folder
In set-up you will need to access the Letters Folder for changing letter
Margins & headings, and creating letter templates.
To Access the Letters Folder:
1) Go to Go>Setup>Settings.
2) Expand the Letters folder (alphabetical order) by clicking the “+” sign next to the
Yellow Letters Folder.
•
Margins
•
Header
•
Letter Templates
86
Margins
To Set up Margins for Letters:
1) Click on Margins. In the right hand side of the screen the margin settings will
display.
2) Click the Change Button. The Change Margins window appears.
3) Enter the margins for Left, Right, Top, Bottom in inches.
4) Click on OK to save the margins.
Margins for Letter templates are now set up.
87
Headers
Edit Toolbar for formatting
and spell check
To Set Up Headers For Letters:
1) Go to Go>Setup>Settings>Letters>Header.
2) Select Change Letter Header. The Change Header window opens.
3) Add, overwrite, delete, or change text as necessary. To remove a data symbol,
overwrite or delete its definition.
4) To format the header text and check spelling, use the Edit toolbar.
5) To add page numbers:
•
Place your cursor in the text area where you want to insert the page
number.
•
Click Insert Page Number. The page number symbol is inserted.
6) To use a data symbol to insert information specific to a particular patient,
document, user, or location of care:
•
Place your cursor in the text area where you want to insert the data
symbol.
•
•
To find a data symbol to insert, enter all or part of a symbol name, then
click Find.
•
Select the data symbol. (Refer to Symbol Help as needed.)
•
7) Click OK. The header is created.
88
Example of a letter header
Letter
Header
Letter
Body- Pulls
from the
Letter
Template
An example of a letter showing the letter header at the top.
To Test Your Letter Header:
1) From a patient’s chart, select the Print button.
2) Select & expand the Letters folder on the left side of the window.
3) Highlight a letter to use.
4) Print or Preview the letter.
Note:
Some Practices may wish to include a logo in the letter header. The maximum
total allowable size of a letter header is 64000 bytes. If your logo, combined with
any other data entered in the header exceeds this limit, you will need to make
adjustments to your logo image, etc.
89
Letter Templates
For Organizing Letters into
a Folder Structure
Clicking these
buttons affects
individual Letter
Templates.
Letter Templates can be organized in folders and subfolders so they are
more easily retrieved by the user.
To Add a New Folder to the Directory Tree:
1) Click on the yellow folder in the middle pane in which you want the new folder to
reside.
2) Click the New Button and enter the folder name.
3) Click OK.
To Move a Folder up or Down in the Directory Tree:
1) Click on the folder that you wish to move.
2) Click the Move Button on the left side of the screen.
3) In the “Move to Selected Folder” window, highlight the folder to move the folder
to.
4) Click OK.
90
Creating Letter Templates
Select
the
Folder
Here
Create
Letter
Here
The letter templates area allows creation of custom letters. MedicaLogic Expression
Language (MEL) and Data Symbols may be utilized to create letters that pull patientspecific information from the database. Note: When building letters, you are not able to use
quick text.
To Create a Letter Template:
1) Select the folder that should contain the letter template.
2) Under “Letter templates in”, click New and the Letter template window opens.
3) For Name, enter the letter template name.
4) Enter static text or other elements you want to include in letters using this template.
5) To insert a data symbol as part of the text, do the following:
•
Place the cursor at a point in the letter where you need to insert a data symbol.
•
Select Insert Symbol and the Insert Symbol window opens.
•
Select the data symbol. (Refer to Symbols Help as needed.)
•
Click OK and you return to the Letter Template window.
6) To change the default margin settings for the selected letter template, do the following:
•
Click Margin Settings Button. The Change Margins window open.
•
For Left, Right, Top, and Bottom, enter the margin settings in inches.
•
Click OK and margins for selected letter template are changed.
7) Click OK and the letter template is created.
91
Inserting Data Symbols
In addition to typing static text, you can insert data symbols into letters. Data
symbols are used to extract information from the database. A data symbol
references a particular type of data, such as a patient’s name, address, current
medications, or current observation values. When you use a data symbol, that type
of data is retrieved from the database for your current patient.
Example From the Letter Shown Above:
Cholesterol: {OBSANY("Cholesterol")}
This will pull the value of the most recent cholesterol into the letter.
The observation term is required, and is an argument that describes how to
interpret the OBSANY data symbol.
Refer to Symbol Help for additional information.
92
Lesson 9: Registration
Folder
•Registration Folder
•Edit Defaults
•Create New or Edit Insurance Co & Plans
•Create New or Edit Professional Contacts
93
Registration Folder
In set-up you will need to access the Registration Folder.
To access the registration folder:
2) Expand the Registration folder (alphabetical order) by clicking the “+” sign next
to the Yellow Registration Folder
•
Defaults
•
Ins. Co. and Plans
•
Professional Contacts
94
Defaults
Set up registration defaults to save time when registering new patients in Centricity
EMR. The same registration defaults are shared by all locations of care on this
Centricity EMR database. When you change the patient registration defaults, your
changes do not affect patient information entered previously. Only new patient
registration information is affected.
To Set up Identifier Defaults in Registration:
1) Enter the following default patient identifiers:
•
Enter the Medical Record No. Label or patient medical record number
(MRN) label. If your clinic or enterprise typically calls the Medical Record
Number by another name, such as Chart No. or Med. Rec. No., you can
use registration defaults to change the label to the term that's most familiar
to your staff.
•
Enter the External ID Label (used with DemographicsLink). This name
makes it easier for users to recognize patient ID numbers that are imported
from your practice management system.
•
Enter the Patient Identifier Preferred for Printed Materials as the default
identifier displayed on printed information for patients.
Note: Setting the Demographic defaults (lower portion of screen) is not
recommended if your patient demographics are coming from a Practice Management
System via interface.
95
Ins. Co. and Plans
Insurance Companies and Plans are automatically populated when importing
patient demographics from a practice management system.
Plans (i.e. HMO, PPO, etc.) and Formularies associated with the insurance carriers
can be updated here.
96
Professional Contacts
Professional contacts encompass pharmacies, insurance companies, service
providers (for orders), and Other Businesses (employers/vendors).
To Create a Professional Contact:
1) Select the New button and the new professional contact window will display.
2) Enter the name, abbreviation, address, and phone for the professional contact.
3) NOTE: If the professional contact is a pharmacy select the “Is Pharmacy”
checkbox. If the professional contact is going to be a practice used for referrals,
select the “Is Order Provider” checkbox.
97
Professional Contacts: Pharmacies
An example of a pharmacy created in Centricity EMR.
98
Lesson 10: Reports Folder
•Reports Folder
•Add New or Edit Reports
•Edit Reports: Administration
99
Reports Folder
In set-up you will need to access the Reports Folder.
To access the reports folder:
2) Expand the Reports folder (alphabetical order) by clicking the “+” sign next to the
Yellow Reports Folder
•
Reports
•
Administration
100
Reports
In the Centricity EMR Crystal Reports Writing class, this area is focused on more
heavily. This area allows folders to be setup and associated with new reports that
are created in the Crystal Reports software.
The report category allows you to select which inquiry type to run against the report.
NOTE: If General is selected, the report will not be run against an inquiry.
101
Reports: Administration
The administration folder allows reports to be secured based on location of care and
network folder access. This area is also addressed more fully in Centricity EMR
Crystal Report writing.
102
Lesson 11: System Folder
•System Folder
•Edit Auditing
•Create New or Edit Confidential Documents
•Create New Document Types
•Edit Locations of Care Printing Defaults
•Edit Flags Defaults
•Edit Workstation Descriptions
•Edit Licensing
•Edit Optional Modules
•Edit Security
•Enable Server Selection
•Edit Server
•Edit Faxcom
•Import Clinical Kits
•Export Clinical Kits
•Edit CCOW
103
System Folder
In set-up you will need to access the System Folder.
To access the System folder:
2) Expand the System folder (alphabetical order) by clicking the “+” sign next to the
Yellow System Folder.
104
Auditing
Centricity EMR automatically monitors and logs many user activities, including user
and workstation IDs, user actions, date and time, charts accessed, and other
information, such as report or document names, clinical values changed and actual
value changes. For a detailed list of audited activities, see Auditing Centricity EMR
access and activities.
Note: Changes to clinical values and chart documents are tracked via Document
contribution logging.
When all auditing options are enabled, database storage requirements increase
significantly. To save space you can choose not to track certain activities such as
viewing, previewing, printing, or faxing of documents with a confidentiality type of
Normal.
NOTE: Activity involving confidential documents and sensitive charts is always
audited and cannot be turned off.
105
Confidential Documents
Confidential Document types are setup in the top portion of the screen. Additions
can be made to this list by clicking the top “New” button.
Reasons why someone would need to retrieve a confidential document via access
on demand are seen in the center portion of the screen. Additions can be made to
this list by clicking the lower “New” button.
You can also indicate whether or not users can “free text” a reason for access on
demand via the checkbox.
Finally, the warning message seen by users can be edited in the lower portion of
the screen.
Note: The EMR application automatically creates a new privilege “tree” for each
new confidential document type created (Access on Demand,
Classify/Declassify, Print, and View privileges). You will need to set confidential
document access privileges as appropriate for new confidential document types.
106
Edit Document Types
This area allows for setup of additional document types that do not come standard
with the system.
The standard document types cannot be edited and are not even seen in this area
(i.e. lab report, office visit, phone note, rx refill, etc.).
To Setup a Document Type:
1) Click New and a New document type window appears.
2) Type the document type name and the abbreviation for the document type.
3) Click OK to save the document type.
Note: The EMR application automatically creates two document signature
privileges for each new document type (the Sign privilege and Additional
signature required privilege). You will need to set document signing privileges as
appropriate for the new document types.
107
Location of Care Printing Defaults
To Specify Location of Care Printing Defaults:
1) Do one of the following:
•
To display the patient's home location in the letterhead for patient-based
printouts, select Patient’s Home Location.
•
To display the user's current location in the letterhead for patient-based
printouts, select User’s Current Location.
108
Alerts/Flags
One user for the entire database should be setup to receive system warning flags.
Note: These messages are usually very technical in nature.
This area also allows you to indicate how many days the system will retain deleted
alerts & flags.
109
Workstation Description
This area allows for optional set up of workstation descriptions. If you opt to set
these, this would need to be done on each workstation. If workstation descriptions
are not set up, the machine name(s) will be used.
The EMR application uses the workstation descriptions when it displays messages
from the system, such as conflicts between two users trying to work in the same
area of the EMR application at once.
110
Licensing
If needed, enter the New License Count and Signature Key exactly as provided by
a GE representative.
To activate ImageLink, select Enable ImageLink. ImageLink allows Link Logic to
import links to external attachments, such as x-rays or ultrasound results.
NOTE: To use ImageLink, you must first have a signed service agreement.
Checking Enable does not automatically give you a license to use it.
111
Optional Modules
Check Enable Appointments to turn on the ability to view and/or schedule
appointments within Centricity EMR.
To allow all users to send different types of documents to specific printers with
specific paper for those documents, check Enable task-based printing. (This gives
access to Select Printers from the Options menu within the EMR application.)
Note: Use caution when enabling task-based printing as this option applies to all
users. Clinics that use Citrix and Windows Terminal Servers in large environments
may experience problems with task-based printing, such as print jobs being sent to
the wrong printer or users seeing printers to which they do not have access.
To use a third-party messaging application with the EMR application, check Enable
messaging features.
For Centricity EMR to interoperate with Centricity Business Solutions, “Enable
Interoperability” must be checked (license required).
112
Security
Definitions:
•Idle user timeout: This allows the administrator to set a specified time when the user is
automatically logged off after a period of inactivity in Centricity EMR. Any mouse or keyboard
action (within Centricity EMR) can reset the timeout countdown. The recommended setting is
15 minutes.
•Display Duplicate Login Messages: Centricity EMR allows a user to log in to more than one
workstation. If a user is logged in simultaneously at more than one workstation, they will
receive a message, however still be allowed to login. The recommended setting is checked.
•Expiration (days): Passwords can be set to expire after a set number of days. To turn off this
feature, enter zero - “0”. The recommended setting is 90 days.
•Minimum Size: Allows for setting the minimum number of characters (between 1 and 16)
required in all new passwords. The recommended setting is 8 characters. Note: Zero (0) sets
the minimum length to one character (2 characters if Require Alphanumeric is also checked).
•Number Retained: Set the number of passwords stored in history (between 0 and 5). The
recommended setting is 5. Note: This prevents users from recycling one or two passwords
and reduces the chance of unauthorized access.
•Require alphanumeric: This setting makes passwords harder to guess. If this box is
unchecked, users can use all letters or all numbers in a password. Setting this option requires a
minimum password size of 2. Recommended setting: checked.
•Require different than user ID: When enabled, Centricity EMR checks for the user name in
the password. For example, if this box is checked, hwinston could not log in with the passwords
hwinston, hwinston1, or @hwinston. Recommended setting: checked.
113
Server Selection
This feature allows you to enable multiple server selection.
If you have more than one Centricity EMR database, select Enable Server
Selection to allow a Centricity EMR user to select the database server to use when
logging in.
114
Faxing
If you are using integrated or non-integrated faxing with Centricity EMR, you must
designate a fax printer driver. Install the fax driver before completing these steps.
Refer to the documentation sent with your faxing equipment for installation
instructions.
NOTE: If Biscom Fax Printer is not in the list, confirm that integrated faxing was
selected when Centricity EMR was installed on the workstation and reinstall it, if
necessary. If integrated faxing is installed and you do not see the Biscom Fax
Printer driver, contact Centricity EMR Support.
115
Faxcom
The faxcom server can be identified here if using the Centricity EMR Integrated
Faxing solution.
116
Import Clinical Kits
You Can Import Clinical Kits From:
•
The KnowledgeBank Web site—a clinical content exchange area. Search through
hundreds of high-quality Centricity EMR clinical content items built by real users.
•
Your network staging area — the network directory where Centricity EMR was originally
installed. If you're not sure where the staging area is, ask your system administrator.
•
Another drive accessible from your PC
•
Another location on your network
•
The hard disk on your PC
To Import Clinical Kits: (Proper privileges required.)
1) Navigate to Go>Setup>Settings
2) Expand the System folder and highlight Import Clinical Kits.
3) Click the Import Clinical Kit button.
4) Navigate to the location where the clinical kit was downloaded / stored.
5) Find & select the file with the .ckt extension.
6) The clinical kit will download to the database.
7) The downloaded item location will be noted in the Results area of the screen.
117
Export Clinical Kits
You can export clinical content when you want to move clinical content from one EMR
database to another, for example when you want to:
•
Move clinical content to a different EMR installation (or clinic).
•
Move from a test database (single-user or network training) to a live, production
database.
•
Back up clinical content prior to importing new content or upgrading to new EMR
releases.
To Export Clinical Content: (Proper privileges required.)
1) Navigate to Go>Setup>Settings.
2) Expand the System folder and highlight Export Clinical Kits.
3) In the Available Components list, select the category that contains the component you want.
4) Do one of the following:
•
To select a specific component, click Add.
•
To add the whole category, click Add All.
5) Select Export Clinical Kit.
6) Enter the kit name and location to store the resulting clinical kit file (kit name.ckt).
7) Click Export Clinical Kit to export all items in the Clinical Kit Contents list to a new or existing
clinical kit.
Note: Exported clinical kits cannot be imported into prior versions of the EMR application.
118
CCOW
CCOW is the acronym for Clinical Context Object Workgroup. CCOW refers to the
CCOW technical committee within Health Level Seven (HL7), which produced the
context management standard that defines how applications may be linked so that
they "tune" to the same context.
Context management software permits users to access multiple clinical applications
that share and maintain specific contexts, such as current user or patient. For
example, a user might need access to data for the same patient in Centricity EMR,
an in-patient EMR, and in a practice management application. Independent
healthcare applications linked through context management remain synchronized
even when a context changes, for example, when the user selects a different
patient. When context data changes in one application, the other applications react
accordingly.
119
Lesson 12: Web Services
Folder
•Web Services Folder
•Create New or Edit Internet Sites
120
Web Services
In set-up you will need to access the Web Services Folder.
To access the Web Services folder:
2) Expand the Web Services folder (alphabetical order) by clicking the “+” sign
next to the Yellow Web Services Folder.
121
Web Services
Default site information is set up for: Clinical Web Services (CWS), Dosing
calculator, Growth Charts, Medscape problem search, and Messaging.
The URLs for Clinical Web Services (CWS), Dosing calculator, Growth Charts, and
Medscape problem search should not be changed.
The messaging URL can be changed to a URL for a third-party messaging web
site.
These URLs contain content not reviewed or controlled by GE Healthcare, and are
provided for your convenience.
122
Lesson 13: Orders Folder
•Orders Folder
•Orders Definitions
•Create New or Edit Service Providers
•Create New or Edit Modifiers
•Order Defaults Folder
•Edit Referral Order Defaults
•Edit Tests & Procedures Order Defaults
•Edit Services Order Defaults
•Edit Incremental Superbill
•Codes & Categories Folder
•Create New or Edit Referral Codes & Categories
•Create New or Edit Tests & Procedures Codes & Categories
•Create New or Edit Services Codes & Categories
•Create New or Edit Order Sets
•Create New or Edit Custom Lists
•Create New or Edit Orders: Ins. Co & Plans
123
Orders Folder
In set-up you will need to access the Orders Folder.
To Access the Orders Folder:
2) Expand the Orders folder (alphabetical order) by clicking the “+” sign next to the
Yellow Orders Folder.
124
Orders: Service Providers
Service Providers are other practitioners, labs, therapists, clinical staff, and imaging
centers, or anyone who provides a service through orders. The same list of service
providers is shared by all locations in a Centricity EMR database and includes
providers used by other locations of care that have implemented orders. Service
providers normally do not work in the same office as the care provider and often are
not associated with the care provider’s clinic.
Once service providers are set up, you can associate approved or preferred service
providers with a specific insurance plan for each order code or category.
To Set up a Service Provider:
2) Type the Last Name, First Name, and Specialty of the service provider
3) In the select organization area, select the organization (pulling from the
professional contacts list) which the service provider belongs.
4)Click OK to save the service provider in Centricity EMR
TIP: Set up organizations or facilities first in Registration>Professional Contacts,
then set up actual providers here & associate to organizations / facilities in the list as
applicable.
125
Orders: Modifiers
Modifiers used for billing purposes should be listed for use with the orders
module. Modifiers are a clinical kit that can be exported/imported in Centricity
EMR.
To Add a Modifier:
2) In the code field, type the 2-digit modifier
3) In the description field, type what the modifier represents.
4) Click OK to save the modifier
Note: Once you have added a modifier, you cannot change the modifier code.
126
Order Defaults
When the order defaults folder is expanded, the following items appear:
• Referrals
• Tests and Procedures
• Services
• Incremental Superbill
Each location of care has its own set of order defaults, enabling different locations
to set up order defaults that work for their style of practice. For example, each
location can have a different referral coordinator who administers referral orders.
Note: The rest of orders setup (custom lists, service providers, order codes, and
categories) applies to the entire Centricity EMR database.
127
Orders: Referrals (Defaults)
To Set Up Order Defaults for Referrals:
1) Select the Referrals order type.
2) Select the location of care for which you want to change order defaults.
• Click Change.
• To use the defaults inherited from the location of care above the selected LOC in the
hierarchy, click Use Parent Settings.
4) If you clicked Change in the previous step, do the following:
• To designate the flag recipient (order administrator) for this order type at the selected
location of care, enter or select the user name using the binoculars icon. Once the
administrator is set up, Centricity EMR automatically sends the administrator a flag
whenever an Admin Hold order is signed.
• Identify the default form to use when printing this type of order. If you select No Form,
no form is printed when the order is signed.
• Select a pre-authorization option: Required or Not Required.
• Indicate what to do when this order is signed. For referral orders, the options are
Admin Hold and In Process.
5) Select the following options:
• To indicate that orders of this type are, by default, covered by insurance, check
Covered.
• If orders of this type, by default, require additional information, check Additional
Information Required. (When setting up an order code, you indicate what information is
required. On the chart’s Update Orders screen, the paper/pencil icon alerts users that
information is required for this order.)
• If orders of this type must, by default, show a diagnosis in order to be approved by
insurance, check Diagnosis Required. (On the chart’s Update Orders screen, the red
flag icon alerts users that this order must have an associated diagnosis.)
128
Orders: Tests & Procedures
(Defaults)
To Set Up Order Defaults for Tests & Procedures:
1) Select the Tests & Procedures order type.
• Click Change.
• Identify the default form to use when printing this type of order. If you select No Form, no
form is printed when the order is signed.
• Select a pre-authorization option: Required or Not Required.
• Indicate what to do when this order is signed. For Tests & Procedures orders, the
options are Admin Hold and In Process.
Covered.
Information Required. (When setting up an order code, you indicate what information is
required. On the chart’s Update Orders screen, the paper/pencil icon alerts users that
information is required for this order.)
129
Orders: Services (Defaults)
To Set Up Order Defaults for Services:
1) Select the Services order type.
• Click Change.
• Identify the default form to use when printing this type of order. If you select No Form,
no form is printed when the order is signed.
• Indicate what to do when this order is signed. For service orders, the options are
Admin Hold, In Process, and Complete.
Covered.
Information Required. (When setting up an order code, you indicate what information
is required. On the chart’s Update Orders screen, the paper/pencil icon alerts users
that information is required for this order.)
130
Orders: Incremental Superbill
Incremental Superbill: A superbill that is printed when orders are signed but only
contains those specific orders.
Each location of care has its own set of superbill defaults, enabling different
specialty clinics to set up defaults that work for their style of practice. When you set
superbill defaults for a particular location of care, those default settings apply to all
locations below that location, unless you change them.
131
Order Categories
Set Up New
Categories Here
Click New to Enter Any
Applicable Plan-Specific
Information for the Category
The Codes & Categories section of Orders set up is divided into 3 sections:
•
Referrals
•
Tests & Procedures
•
Services
To Set Up Categories – Basic Steps:
1) Select the Order Type – Referrals, Tests & Procedures, or Services - from the yellow Codes
& Categories folder on the left.
2) Click the New button at the top of the screen. The Add Category window displays.
3) Type the name of the category.
4) Apply any plan-specific defaults to categories, as applicable. (See next page.)
5) Click OK to save.
132
Orders: Plan-Specific Defaults for
Referrals, Tests & Procedures
This Window
Looks the
Same for
Referrals and
Tests &
Procedures
To Set Up Plan-Specific Defaults for Categories (or Individual Codes):
•
Identify the insurance plan for the order category or code. To set the insurance plan as the
default for the order category, click the Default Plan Information for Category box at the
bottom of the screen. (This choice is available only if no other plan has been selected as the
default for this category.)
•
Add approved and preferred service providers.
•
Select a preauthorization option: Required or Not Required.
•
Indicate what to do when this order is signed. For test and referral orders, the options are
Admin Hold and In Process.
•
Enter an optional comment for the order administrator or authorizing provider. (When the
order’s primary coverage is the selected plan, the comment appears in the order's Insurance
Notes area on the Update Orders Details tab.)
•
Select the form to use for printing pre-authorization forms for the selected insurance plan. If
you select Custom Form, the form you set up will be printed. The default Crystal Reports
form is located in the CRWRPTS directory with a suffix of .RPT. If you have your own form,
browse to its location. If you select No Form, the associated orders are marked “In
Process”, but no form is printed. If you select Plan Form or Category Form, the form for the
selected plan or category will be used.
•
Specify Locations Of Care with specific approved providers. By default, the system selects
all locations of care.
•
Check Covered if this category is covered by the specified insurance plan.
•
If orders must, by default, show a diagnosis to be approved by insurance, check Diagnosis
Required. (On the chart’s Update Orders screen, the red flag icon alerts users that this
order must have an associated diagnosis.)
133
Orders: Plan-Specific Defaults
for Services
Enter Plan-Specific
Defaults for Services
To Set Up Plan-Specific Defaults for Categories (or Individual Codes):
•
Identify the insurance plan for the order category or code. To set the
insurance plan as the default for the order category, click the Default Plan
Information for Category box at the bottom of the screen. (This choice is
available only if no other plan has been selected as the default for this
category.)
•
Indicate what to do when this order is signed. For service orders, the options
are Admin Hold, In Process, and Complete.
•
Enter an optional comment for the order administrator or authorizing provider.
(When the order’s primary coverage is the selected plan, the comment
appears in the order's Insurance Notes area on the Update Orders Details
tab.)
•
Check Covered if this category is covered by the specified insurance plan.
•
If orders must, by default, show a diagnosis to be approved by insurance,
check Diagnosis Required. (On the chart’s Update Orders screen, the red
134
Order Codes
To Set Up Codes Within Their Respective Categories – Basic Steps:
Note: All 3 areas look the same, however the CPT code should be set up within the order
type that it belongs.
1) Select the Order Type – Referrals, Tests & Procedures, or Services - from the yellow
Codes & Categories folder on the left.
2) Highlight the appropriate category at the top of the screen.
3) Click the New button in the bottom section of the screen to enter the code desired.
4) Click the “Find CPT Code” button to search for a CPT code.*
5) Change the description to user-friendly terminology as needed.
6) Enter plan-specific defaults as applicable for the code. (See previous pages.)
7) Click OK or Save and Continue to enter more codes within the category.
*NOTE: If the code you are setting up is not a CPT code, click into the code field and type
the code desired.
135
Orders: Set Up Codes
for Referrals
To Set up Referral Codes: Follow the basic steps on the previous page. Also see plan-specific
instructions on page 134, as applicable.
Note: “Dummy codes” can be set up for referrals since these are not billed by your clinic. These
will need to be typed directly into the fields instead of searching for CPT Codes. (Example:
Code = ENT CONS, Description = ENT Consult)
Optional Fields for Referral Order Codes:
• In Duration, enter the length of time that the referral can be in effect and specify the time
increment (days, weeks, or months).
• Identify the Maximum visits that the referral will cover.
• Check Common if you want this order to appear in the list of commonly used orders. (Common
codes appear on the Order Categories tab in the Orders Module.)
• Check Additional Information Required to indicate that additional information is required. For
example, if a referral is for nutrition counseling, the provider must indicate what type of nutrition
(low cholesterol, diabetic, etc). Note: If you choose this option, you must enter a Prompt
indicating what information is required.
• In Prompt, enter a word or phrase that will appear whenever an EMR user selects this order for
a patient. This prompt is a reminder for providers to enter the required information. It should
indicate what additional information the clinical staff must enter for the code.
9 For example, if a referral is for nutrition counseling, the provider must indicate what
type of nutrition (low cholesterol, diabetic, etc.).
136
Orders: Set Up Codes for
Tests & Procedures
To Set up Codes for Tests & Procedures:
Follow the basic steps on page 136. Also see plan-specific instructions on page 134,
as applicable. Note: If you have an outbound electronic orders interface, the codes
set up here must exactly match the receiving system.
Optional Fields for Tests and Procedures:
•
In Quantity, indicate how many tests must be done. For example, hemoccult x 3.
•
In Priority, indicate how urgent the test or procedure is: Normal, Urgent, or Stat.
•
Check Common if you want this item to appear in the list of commonly used orders.
(Common codes appear on the Order Categories tab in the Orders Module.)
•
Check Additional Information Required to indicate that additional information is required.
For example, for a leg x-ray order, you need the provider to indicate Left or Right. Note: If
you choose this option, you must enter a Prompt indicating what information is required.
•
In Prompt, enter a word or phrase that will appear whenever an EMR user selects this
order for a patient. This prompt is a reminder for providers to enter the required information.
It should indicate what additional information the clinical staff must enter for the code.
9 For example, for a leg x-ray order, you can enter a prompt of Left or Right to
remind the clinical staff to enter that information. (The prompt also prints on order
forms and superbill reports.) TIP: Separate input fields with colons ( : ) in the
prompt. This allows the user to press the Tab key to move from one input field to
the next.
137
Orders: Set Up Codes
for Services
To Set up Codes for Services:
Follow the basic steps on page 136. Also see plan-specific instructions on page 135, as
applicable. If the code you are setting up is not a CPT code, click into the code field and type the
code exactly as it is set up in the practice management system (i.e. – “J” codes).
Note: If you have an outbound procedures interface to your practice management system, the
codes set up here must exactly match the receiving practice management system.
Optional Fields for Services:
• Enter the number of Units required. For example stitches are billed in five increments, so if a
patient gets 15 stitches that would be three units of service.
•Check Common if you want this item to appear in the list of commonly used orders. (Common
codes appear on the Order Categories tab in the Orders Module.)
•Check Additional Information Required to indicate that additional information is required. For
example, for a leg x-ray order, you need the provider to indicate Left or Right. Note: If you
choose this option, you must enter a Prompt indicating what information is required.
•In Prompt, enter a word or phrase that will appear whenever an EMR user selects this order for
a patient. This prompt is a reminder for providers to enter the required information. It should
indicate what additional information the clinical staff must enter for the code.
9 For example, for a leg x-ray order, you can enter a prompt of Left or Right to remind
the clinical staff to enter that information. (The prompt also prints on order forms and
superbill reports.) TIP: Separate input fields with colons ( : ) in the prompt. This allows
the user to press the Tab key to move from one input field to the next.
138
Orders: Order Sets
An order set is a grouping of related order codes that can be named and added to an orders custom
list. For example, a cholesterol order set can include orders for a blood test, exercise routine, and
referral to a dietician. When the order set is selected, all of the individual orders in that set are
automatically checked. Note: Order Sets cannot be set up until Order Codes & Categories have been
set up.
To Set up Order Sets:
1)Go to Go>Setup>Settings
2)Select Orders
3)Select Order Sets
4)Select New to create a New Order Set
5)Enter a name (up to 32 characters)
6)Select OK
To Update the Order Codes in an Order Set:
1)Select New
2)Select an Order Type (service, test, or referral).
3)In Orders in Category, select the codes you want on the order set and do the following:
•
To select multiple codes, click Save & Continue after each selection.
•
Organize the order set.
NOTE: Any changes to order set names will be reflected automatically in all custom lists that include
that order set.
You cannot delete an order set if it is currently defined as part of an order custom list.
139
Orders: Custom Lists
Custom lists can contain a combination of services, referrals, and tests & procedures. Custom lists can only
include orders that have already been set up in Centricity EMR. You can include the same order code(s) in
multiple custom lists.
The same list of order custom lists is shared by all locations of care in the Centricity EMR database. Name order
custom lists with a clinic prefix so that all custom lists for each location are grouped together alphabetically.
Specialty clinics should consider sharing specialty custom lists.
To Create a New Custom List:
1)Select New and enter the custom list name.
2)Select OK.
NOTE: Any changes to custom list names will be reflected automatically in all custom lists with that name.
To add Codes, Order Sets and Header to the Custom List:
In the NEW Outlined Area in the bottom section of the screen:
1)Select Code, Order Set, Header, as applicable.
2)Select appropriate Code, Order Set, Header.
3)Select OK.
4)Continue until customs list is complete.
If you do not want to allow users to change a custom list’s organization from the patient’s chart, uncheck Allow
custom lists to be organized from Update Orders.
NOTE: If you enable this option, the user will be changing the organization of custom lists shared by the entire
location of care.
140
Orders: Ins Co and Plans
Insurance Companies and Plans in the Orders Settings folder is the same table as
in the Registration folder
NOTE: If you are working with an integrated Practice Management Application this
information can be configured in the Interface to import into Centricity EMR.
141
Orders: Definitions
•
•
•
•
Approved Service Providers
Comment
Covered
Diagnosis Required
Approved Service Providers: You can set up as many approved providers for
an order or a category as you need to. You can designate only one of them as
the preferred service provider. Orders are sent to the preferred provider unless
the ordering provider chooses a different one.
Comment: Contains administrative details about the order or category of orders.
The provider sees this text at the time he or she selects the order. The order
administrator also sees this text when handling these orders. Some examples:
“All flu shots for Coverly PPO patients are not covered except for asthmatics and
patients over 65” or “Individual psychotherapy is not covered without a diagnosis.”
Covered: This indicates whether an order is covered. If the order is not covered,
Centricity EMR warns the provider placing the order.
Diagnosis Required: If this box is checked, Centricity EMR warns the order
administrator that a diagnosis is required before the order can be sent. The order
administrator or provider sees the red flag symbol next to the order. If the
disposition when signed is Administrative Hold, selecting Diagnosis Required
affects only the administrator; it has no effect when the provider selects the order
and signs it.
142
Orders: Definitions
• Disposition When Signed
– Administrative Hold
– In Process
– Complete
• Order Administrator
Disposition when Signed: This indicates what should happen to the order when
the provider signs it. There are three choices:
• Administrative Hold means the order is finished from the provider’s point
of view, and Centricity EMR sends a flag to the administrator saying the
order is On Hold. The administrator can then do tasks such as getting
preauthorization before sending the order.
• In Process means the order is printed and becomes a permanent part of
the chart; there is nothing else to be done but pick up the papers from the
printer and send or fax them to the consulting physician.
• Complete (Services only) means that the service has actually been done
and any results have already been entered. Nothing else needs to be done to
a completed order, and there is typically no paper output.
Order Administrator: This person receives a flag whenever an order is put on
Administrative Hold. See “Disposition when Signed” for more information about
administrative hold. For each location of care, you can designate up to three
different order administrators: one for Referrals, one for Tests and Procedures, and
one for Services. There may be one person in your clinic who usually does this job,
or there may be several.
143
Orders: Definitions
• Pre-authorization
– Required
– Not Required
Preauthorization: There are two possible settings for preauthorization: Required
and Not Required. Both of these settings affect the person for whom the forms are
printed—the provider, the insurance company, or both. The settings for printing
forms are in the Referral or Test Coordination dialog box, which the order
administrator sees.
• Required means that the insurance company requires preauthorization.
The administrator must enter a preauthorization number before printing a
copy of the order for a service provider.
• Not Required means an authorization number is not required. A copy of
the order may be printed for the service provider without entering a
preauthorization number.
144
Lesson 14: LinkLogic Folder
•Orientation of LinkLogic Folder
•Defaults
•Stations
•Relationships
•Task Options
•Import Interface Kits
145
LinkLogic: Defaults
LinkLogic enables the efficient and intelligent sharing of data among the EMR
application and a variety of external systems, such as practice management,
transcription, laboratory, hospital information, and clinical data repositories.
LinkLogic uses interfaces to share data.
The LinkLogic Defaults Setup determines activity management of interfaced data,
such as automatically removing errors from the activity log as well as removing
warnings and notes.
NOTE: LinkLogic Setup is typically initiated at the time of the Technical Setup of the
Integration and can be updated/maintained during LinkLogic Training.
146
LinkLogic: Stations
The LinkLogic Station Setup indicates the “ DTS” location. Data Transfer Station
(DTS) is a separate program from the EMR application that you set up on a
workstation to automatically process data.
147
LinkLogic: Relationships
A LinkLogic relationship is a description of an interface between the EMR
application and another computer system.
You create a relationship in the EMR application for every interface you use in your
clinic.
A relationship description includes the following information:
•Direction—import or export
•Type—for example, Demographics, Lab Results, Documents
•Data format
•The other computer system’s unique ID
•Patient ID— EMR ID or an external ID
When you add a relationship, LinkLogic creates a corresponding task with
predefined options. The task options describe the behavior of the relationship.
148
LinkLogic: Task Options
When you add a relationship, LinkLogic creates a corresponding task with
predefined options. The task options describe the behavior of the relationship.
149
LinkLogic: Import Interface Kits
An Interface Kit is a collection of files that you import into the EMR application to
enable a Lab Results relationship for a specific vendor. After importing the interface
kit, you can choose your laboratory in the Unique ID/Name list in the New
Relationship screen. Your laboratory must be in the list for you to create the
relationship.
LinkLogic imports the kit and adds the laboratory’s unique name to the laboratory
list in the New Relationship window.
.
150
Lesson 15: Preferences
•Orientation of Preferences Feature
151
Preferences
Preferences are settings that let clinic staff customize the EMR application’s
appearance and behavior. Preferences can be set at three (3) levels and are “best”
setup by group.
•Enterprise preferences are the default preference settings for all clinic staff
members in an EMR database. All new users start out with these preferences.
•Group preferences can be defined for clinic staff members who use the EMR
application in similar ways. You can also create groups for people with similar jobs.
You can assign clinic staff members to groups when you add each user to the EMR
application. Group preferences override Enterprise preferences.
•User preferences apply only to an individual. User preferences override Group and
Enterprise preferences. All clinic staff members can use Setup to change their own
preferences. In some cases, users can change their own user preferences "on the
fly" while they’re using other parts of the EMR application.
NOTE: Individual users have the ability to set their own preferences in this area,
with no special privileges required.
152
Lesson 16: Privileges
•Orientation of Privileges Feature
153
Privileges
Privileges are security settings that define the tasks a clinic staff member can
perform and help ensure the privacy and security of protected patient information.
Privileges are best set up by role. They can also can be set for the user.
The golden key represents that the user has the privilege.
NOTE: A user can have up to five (5) roles. If a user has two (2) or more roles, their
privileges will be based upon the “highest” privilege. This same concept applies if
the user’s privilege is higher than their role then their privilege is based upon their
“highest” privilege.
To assist in setting up privileges, see the following topics in Online Help (F1):
•Add privileges to roles
•Add extra privileges for users
TIP: In the Reports Module, use the Audit Reports “Current User Privileges” and
“Current Role Privileges” to review your set up of Privileges.
154

Centricity Electronic Medical Record 9.0 Setup Training Manual

Transcription

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