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1 Presenter: Jessica Napiza, Software Training Manager Clinical Workflow Best Practices

Clinical Workflow Best Practices in DXE...Clinical Workflow Best Practices 2 Speaker Disclosure Jessica Napiza is anemployee of Henry Schein One. 4 Does this sound familiar? 3 •Helps

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    P r e s e n t e r : J e s s i c a N a p i z a , S o f t w a r e Tr a i n i n g M a n a g e r

    Clinical Workflow Best Practices

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    Speaker Disclosure

    Jessica Napiza is an employee of Henry Schein One.


    Does this sound familiar?

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    • Helps maximize your organization’s efficiency

    • Helps ensure patients get same great dental experience every single time

    • Predictable, accurate results

    • Standardization of dental staff roles and responsibilities

    • Provides scalable solutions to support organizational growth and changes


    How workflows can benefit you

    Recommended Clinical Workflow for Dentrix Enterprise


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    1. Confirm Clinical Readiness

    2. Conduct a Patient Medical History Review

    3. Clinical Charting

    4. Manage Treatment Plans

    5. Document Changes/Additions to Planned Treatment

    6. Post Scheduled Procedures Complete

    7. Document Clinical Notes

    8. Schedule Next Appointments7

    Overview of Clinical Workflow

    Confirm Clinical Readiness


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    • Verify patient readiness using More Information

    • Available readiness markers include Patient Tags, Continuing Care, Treatment Plans, Treatment Requests and more


    Patient Clinical Readiness with More Information Window


    • Front office checks in the patient and confirms they are ready for treatment.

    • Clinical team confirms patient is ready for treatment by updating the Appointment Status to Seated.

    • Next, open the patient’s Patient Chart to begin clinical exam.


    Clinical Readiness Communication

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    Conduct a Patient Medical History Review


    1. Update a patient’s Problems, Allergies and Medications

    2. Complete a Patient Health Assessment

    3. Determine Pain Level

    4. Update Smoking Status


    Reviewing Patient Medical History

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    • Indicate any changes by selecting Change

    • The medical alerts window will open once the Medical History is reviewed, allowing you to make the necessary updates


    Step 1: Review Problems, Allergies and Medications

    • Track patient’s vitals signs, height, weight, etc.

    • Some measurements are necessary for Meaningful Use


    Step 2: Complete a Patient Health Assessment

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    • Document notes about patient pain.

    • What is their chief complaint?

    • Workflow Insight: Pain level of 4 or greater –activates additional pain questions in today’s Clinical Note


    Step 3: Determine Pain Level

    • The Smoking Status menu allows for tracking of current smoking status.

    • Each change in Smoking Status is documented in History.


    Step 4: Update Smoking Status


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    • To have the Medical History Review dialog box open when the Patient Chart opens, a Global Setting must be enabled. o Contact a support representative for assistance at 1-800-459-8067 (option 2)

    • If you selected Change for any of the problems, medications or allergies, the Medical Alerts window opens automatically after you click OK. This allows you to make the appropriate changes to the patient’s medical alerts.o Help File: Assigning Medical Alerts


    Best Practices – Medical History Review

    • What does your practice do differently when conducting Medical History reviews?

    • What do you do the same?


    Let’s Talk Workflows


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    Clinical Chartingof Conditions, Existing and Treatment Plan Procedures


    1. Confirm Chart Provider

    2. Update Primary vs Permanent Dentition

    3. Complete Hard Tissue Exam

    4. Link Conditions to Treatment Planned Services

    5. Select Treatment Plan Approval Status


    Clinical Charting

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    • Several ways to change the charting session provider:o Setting up a Default Chart Provider

    o Changing Provider from the Patient Chart

    o Change Provider Override in Clinic Resource Setup


    Step 1: Confirm the Chart Provider

    • In the Office Manager, click Maintenance > Practice Setup > Practice Defaults…o Patient’s Primary provider

    o Specify a provider

    o Provider from Selected Appointment– Must have an appointment selected from the

    Appointment Book or More Information window for this to work


    Setting up a Default Chart Provider

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    • From the Patient Chart, click File > Change Provider.

    • Select the appropriate provider

    • All treatment will now be entered under the new provider.

    • When you switch to a different patient, the chart provider will change back to the Default Chart Provider.


    Changing the Provider in the Patient Chart

    • From the Office Manager, Click Maintenance > Practice Setup > Clinic Resource Setup. Then Editthe Clinic Information and click the Settings tab. o Overrides the Default Provider

    – Per Patient – Per Session


    Change Provider Override

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    • Check to see if dentition is an accurate representation of the patient’s teetho Tip: Do NOT change the default


    Step 2: Update primary vs permanent dentition

    • Enter existing treatment, conditions, and recommended treatment as necessary in the graphic charto Assess patient’s current condition

    o Document existing treatment

    o Enter recommended treatment


    Step 3: Complete Hard Tissue Exam

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    • Use the Auto State button to save time

    • Enable Auto-State button to post treatment of the same status (existing, conditions, treatment planned, completed) without having to select the status each time

    • Keeps the status button selected until you disable auto-state


    Tip: Using the Auto State button

    • Workflow Insight: Automate the invalidation of conditions upon completion of a treatment planned procedure.


    Step 4: Link Conditions to Treatment Planned Services

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    • Customize in Definitions

    • Communication tool between front and back office

    • Example Approval Statuses:o Pre-Auth Required, Pre-Auth Sent,

    Approved, Rejected

    • Run the Treatment Plan Approval Status Report


    Step 5: Select Treatment Plan Approval Status

    • Standardize Chart colors across workstations and siteso Help File: Customizing chart colors

    • Enable the option to use paint colors for progress notes. Helps to easily identify conditions vs completed vs treatment planned procedureso Help File: Customizing chart colors

    • Create procedure button templates based on roleo Release Guide: Dentrix Enterprise 8.0.9


    Best Practices – Clinical Charting


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    • What does your practice do differently when charting clinical treatment?

    • What do you do the same?


    Let’s Talk Workflows

    Treatment PlannerManaging Treatment Planned Procedures


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    • Workflow Insight: The Treatment Planner processes will provide your team with the clarity of recommended treatment, treatment sequence and status of treatment cases.


    Treatment Planner

    1. Sequence Treatment Visits

    2. Link Cases

    3. Treatment Plan Review with Patient

    4. Update Case Status History

    5. Sign Consent Forms


    Managing Treatment Plans

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    • Create cases to organize treatment planned procedures

    • Sequence treatment planned services into visits

    • Workflow Insight: You can view treatment plan visits in the Treatment Planner, Appointment Information dialog box and in the More Information Window.


    Step 1: Sequence Treatment Visits

    • Link Treatment Cases

    • Create Alternate Treatment Caseso If you accept one, the other is automatically



    Step 2: Link Treatment Cases

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    • Modify Treatment Planner view layout, as needed.

    • Print Patient Treatment Case, as needed.


    Step 3: Treatment Plan Review with Patient

    • Update Case Status

    • Enter notes regarding the case status change


    Step 4: Update Case Status History

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    • If needed, review and obtain signature on applicable consent forms

    • Workflow Insight: Once the consent form is signed, a copy of the signed consent will automatically be saved in the patient’s Document Center.


    Step 5: Sign Consent Forms

    • Case Status “Referred” allows you to choose the doctor to whom they’ll be referred for the treatment and also updates the Family File referral source for the patient.

    • You can update treatment plan fees from the Treatment Planner for all patients or specific patients, providers, or procedure codes.

    • You can access insurance notes from the Treatment Planner.

    • Treatment Planner settings such as patient friendly descriptions for ADA codes and default case note templates simplify the way you manage and present treatment cases.


    Best Practices – Managing Treatment Plans

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    • What does your practice do differently when managing treatment cases?

    • What do you do the same?


    Let’s Talk Workflows

    Document Changes/Additions to Planned Treatment


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    1. Document Procedure Changes and Set Complete

    2. Review Completed Procedures in Progress Notes


    Document Changes/Additions to Planned Treatment

    • If the procedure changes during a patient’s appointment, do the following:o Reject original treatment from

    Treatment Planner

    o Enter new procedure in the Chart– Preserves original treatment in


    o Set procedure complete from Chart


    Document Procedure Changes and Set Complete

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    • To ensure accuracy, review all completed procedures in the Progress Notes.

    • Verify procedure codes, tooth numbers, surfaces, providers, etc.


    Review Completed Procedures in Progress Notes

    Post Scheduled Procedures Complete



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    • Visits resulting in treatment plan changes or additions were set complete from the Chart.

    • Post scheduled procedures complete from the Appointment Book.


    Set Scheduled Procedures Complete

    • Workflow Insight: The option to set complete treatment from the Appointment Book provides a clear, visual indicator that treatment is complete (gray appointment).

    • When Continuing Care is attached to an appointment, the option to schedule the next appointment appears, driving your team to reappoint.


    Set Appt Procedures Complete from Appointment Book

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    Document Clinical Notes


    1. Access Clinical Notes

    2. Use Clinical Notes Templates

    3. Sign and Lock your Clinical Note


    Document Clinical Notes

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    • Locate today’s clinical note

    • Change provider, if needed

    • Workflow Insight: The Clinical Note will automatically start upon completion of the Medical History Review.


    Access Clinical Notes

    • Use clinical note templates to finalize note.

    • Workflow Insight: The workstation-specific setting to Group Prompts provides the option to view all clinical note prompts at one time.

    • Additional note details can be added or modified once the template has been completed.


    Use Clinical Note Templates

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    • Workflow Insight: Signature security override allows the signer to input their user ID and password to sign, regardless of the user signed in to Dentrix Enterprise.

    • Signature pads enhance the signing process by giving the signer a true signing experience.


    Sign and lock your clinical note

    • There are options in Dentrix Enterprise to automatically have items added to Clinical Notes, such as patient health assessments, prescriptions and medical alert changes.

    • Routine periodic maintenance on your Clinical Note Template categories will ensure you are only using the categories consistent with current clinical applications in your organization.

    • As of Dentrix Enterprise 11.0, you can edit a clinical note directly from the Signature Manager in the Office Manager.


    Best Practices – Document Clinical Notes

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    • What does your practice do differently when documenting clinical notes? What do you do the same?


    Let’s Talk Workflows

    Schedule Upcoming Appointments


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    • From the More Information window, review treatment plans and treatment requests.

    • Schedule new appointments based on treatment needs.

    • Workflow Insight: Appointments scheduled with an attached Treatment Request ensure that the request is marked complete once the appointment is set complete


    Do they need another appointment?

    Clinical Workflow Conclusion


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    1. Confirm Clinical Readiness

    2. Conduct a Patient Medical History Review

    3. Clinical Charting

    4. Manage Treatment Plans

    5. Document Changes/Additions to Planned Treatment

    6. Post Scheduled Procedures Complete

    7. Document Clinical Notes

    8. Schedule Next Appointments59

    Remember This: Clinical Workflow

    • What did you learn today that you can implement in your workflow?

    • Review your clinical workflow with your clinical team

    • Does your office need a workflow analysis?o Our Dentrix Enterprise Training team offers workflow analysis services

    o Purpose is to analyze and provide recommendations on best practice use of the software

    o Contact your Customer Success Manager for more details


    When you get back to your office…

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    • What questions do you have about today’s course?




    • Dentrix Enterprise Resource Center:Knowledgebase articles and Financial Essentials Online Courses available at: https://www.dentrixenterprise.com/support/resource-center

    • Dentrix Enterprise Help Files:https://hsps.pro/DentrixEnterprise/Help/desktop/Dentrix_Enterprise_overview/Dentrix_Enterprise_overview.htm

    • Dentrix Enterprise Blog:Find weekly tips and tricks on how to best use Dentrix Enterprise. https://blog.dentrixenterprise.com/

    Dentrix Enterprise Online Resources