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4010 Moorpark Avenue, Suite 222 San Jose, CA 95117
www.prognocis.com [email protected] Copyright March 2016 – Bizmatics, Inc.
New User/Employee Orientation
to PrognoCIS EHR
Electronic Health Record: The Clinical Side
• This webinar is designed as an overview as to the definition and functionality of the EHR system and is not intended to be a training session. It covers standards and behaviors with regards to User Interface, navigation, and basic/typical workflow.
• A tangible PDF version of this webinar can be accessed on our Resource Center under User Quick Guides.
Resource Center ( )
• Future workflow-oriented and topical webinars will be forthcoming, and we would love to hear your suggestions! Please submit your requests that you would like to know more about in upcoming months.
Free Technical Support: (800) 552-3301
In This Webinar…
• Personalized one-on-one user training is available remotely as well as on-site in hourly or daily increments/packages.
The Big Picture…Technologically Speaking The Database
• Cloud-based – hosted by Bizmatics on our servers; most technical support will be provided by our Help Desk. (At times you may have local ISP issues we cannot resolve.)
• Client Server – hosted locally; most technical issues will be addressed in-house with local IT staff. (Program and Data-related issues should be referred to us.)
• Patient and user level data is shared with PM & Portal and thus is accessed from common tables; however, modular-specific data resides in separate tables (EHR, Portal, and PM).
Navigating the User Interface • Aside from the iPhone app, basic navigation is the same regardless of browser (IE, Chrome, etc.)
• Modules are accessed by tabs/menu drop-downs, icons, or hyperlinks.
• Some functionality/icons appear based on specific scenarios, transactions, or permissions; hence, one user may see an option that another user does not, or an icon may suddenly appear.
*Admin Properties embrill.switching.allow.roles Admin Role / Admin User Role individual user
^Internet Explorer File New Session URL
• Some behaviors can be enabled to improve data-entry efficiency (e.g.: auto-copy, populate, etc.)
Accessing the Data • System properties/configuration* determines who can access each module. One’s Role determines
individual permissions (Read, Create, Update, Delete, Approve) modularly. Additional User Roles may be assigned to customize a specific user’s access or create “Super Users”.
• Browser Settings apply to each device. There can be multiple occurrences of PrognoCIS open at the same time by creating it as a New Session^ within the browser.
Electronic Health Record: The Application
• The URL is the unique/secure electronic address of your database on the server/cloud
Login Screen
• User Name & Password is unique to each user based on user profile definition
Scrolling billboards regularly rotate with important news or
events, tips, etc.
• Interactive links to tech support, sales, industry news, & training schedule & browser settings^
Interactive links
Secure URL
^Browser settings
User Login
• Applicable for each device (desktop PC, laptop, notebook); not associated to a specific user. • Specific to the browser (Internet Explorer, Google Chrome, Safari)
Note: Some browsers may vary from one version to another (such as Internet Explorer).
Browser Settings
Tip: A first line of defense when something does
not seem to be working properly or only works for
some users but not all.
User Theme by Profile Type • User profiles are defined under the Medics master*, which assigns a corresponding Medics Type. • Valid Medic Types are: DR, MA, RN, and ST, and these can be used to define properties as needed.
Dual blue & gray
Dual gray & white
Dual purple & pink
Dual blue & gray
RN
MA
ST
DR
*Settings Configuration Medics
User Interface: Behavior and Navigation
Standards
EHR System Ribbon*
• Navigation Icons • - navigate through the most recent (up to 20 total) EHR pages accessed in that session • - always returns you to the Home Page from wherever you are in the system
• Menu Tabs • Appointments accesses the scheduling module, doctor availability, & appointment reports • Patient accesses patient-level modules, demographics & clinical, current & historical • CPOE is Computerized Provider Order Entry modules (Rx/Refill, Lab, Radiology, etc.) • Messages includes internal email (from users & patients) as well as scanning and attaching • Report module includes reports and graphs specific to EHR data and meaningful use • Settings provides access to system-level master files and configuration tables
• System Tray Icons • Shortcuts to general features at the system level or to focused features in a pop-up which keeps
the current screen active in the background while allowing you to do something else • Static icons (always visible) include Compose Message, Take Appointment, Select Patient,
Resource Center, Help Topics, Information, Session Lock, & Logout • Conditional icons based on system settings include Meaningful Use, Toggle Billing/EMR, Billing
Dashboard) • Situational icons based on user activity include Unread Alerts and Current Encounter
*Always visible and available to all users from any EHR screen. Note: The system ribbon displays differently on the PM side for users who have both.
EHR User Ribbon
• Assign To Providers Note: This feature is not applicable for non-clinical staff (e.g.: Medic Type – ST). • Hyperlink that allows you to associate clinical staff and providers in conjunction with the Home
Page settings, which allows access to all providers/all staff^.
• Inbox Messages* Note: See Training Videos by Module EMR Messages. • Hyperlink to the user’s Inbox, which is common to EHR and Practice Management as applicable • Black font is the total number of messages for each message type • Red font is the number of new (unread) messages for that category • ToDo – messages sent to you by another or by yourself with an assigned Due Date
• Patient Reminders • Hyperlink that facilitates the user in reminding patients of upcoming appointments to confirm
them or to schedule services that are due (such as HM, Vaccinations, or Follow-up). You may also manage custom reminder lists here. Note: This option allows emailing; A similar feature exists on the Schedule Call List screen.
^Admin Properties Home Page home.xxxxxx.showalldocs
*Access to one’s personal Inbox applies for all profile themes in both EHR & PM.
Provider User Ribbon
• CPOE Results Review Bubbles • displays Lab Results that have been received but not yet reviewed by the Provider
• displays Radiology Results that have been received but not yet reviewed by the Provider
• Hyperlinks • Inbox Messages, Clinical Staff/MA, & Patient Reminders apply for providers same as for others • My Preferences displays only for providers (Medics Type: DR) and allows a provider to create
personal preferred lists of templates, codes, and tests that are available only to him/herself and assigned staff
Home Page Appointment Tab
• Defaults to current date’s schedule based upon the user’s specified filters on the Appointment tab.
• allows the user to navigate across different dates or to select a specific mm/dd/yyyy date
• Patient-focused icons access details for only the selected patient/appointment (blue highlighted row)
• This page auto-refreshes every 60 seconds to reflect real-time activity.
• This is the system default view for all users upon his/her initial login.
• The Reason, Room, Comment, and Status* reflects the routing of the patient within the visit.
Patient focused icons
*Admin Properties Codes/Drugs Custom Appt Status
*Visit-specific routing details
Home Page Open Encounter Tab • A cumulative display of all encounters that have been started but not signed off/completed, inclusive
of all dates of service for all providers within the user’s specified filters.
• Serves as a worklist for providers to ensure MU compliance, claim creation (for PM users), and that you do not reach the maximum number of open encounters for the patient*.
*Admin Properties Encounters encounter.max.open
^Note: Filters are applied immediately for the current session and are retained even after logout until they are changed again.
• The Filters… button applies independently to each tab on the Home Page and are specific to the user^.
Common UI Format & Navigation*
• Focused icons apply to only the selected row on the applicable screen
• Check box columns selects a value to be added to or removed from the screen upon clicking the save or ok button in conjunction with the column label, e.g.:
• Del – places a red x in the box and will remove the entry from the screen ( ) • Sel / – places a black check mark in the box and it will add the value to your screen ( )
• Tabular display is a common UI for search and many data entry screens in both EMR & PM
• Data displays in alternating gray lines, with the selected line highlighted with a light blue background
*Applicable when there are multiple records of similar data in a table.
Data Entry & Status Standards Data Entry and Action • Field-exit* is <TAB> key or mouse click into another field. • Upon field-exit, click save or ok to retain the data. • Reset/Cancel will undo changes/restore last saved values.
Auto-complete/Search Fields • - enter the desired value and it will auto-select or scroll to select from a pick list set of values
• - browse/search the master file or enter the desired value and it will auto-fill the field
• - enter a valid calendar date (slashes auto-fill) or use calendar lookup to choose month/year
• - enter an approximate date or use calendar lookup to choose an actual date
• - indicates the data is visible and available to be used on a new/current record.
Data Accessibility Status
• - indicates the records are not available for new/current use but have been preserved historically for data integrity. Note: Typically, this applies at the system/master file level.
• - indicates the data/record is visible and available for new/current use. Note: All screens display only active data by default.
• - indicates the data/record is not available for use; however, any references of it are preserved historically for data integrity Note: Typically, this applies at the individual data element/record level within a master file.
*Data may display in the field but is not actually tagged to the output until you field-exit.
Icon Standards Common Actions system-wide • - multi-search & select one or more values from a pre-defined master file • - add a new record to a database the table or master file
• / - search records within a database table or user-defined master file
• - browse directory to attach a file into database table
• - zoom to view the attached record or file as previously scanned/generated in the table
• - navigation arrows advances backwards/forwards one at a time (arrow without the line) or to the first/last (arrow with the line)
• - preview / print / fax / e-send the document
Icon Color/Meaning • Patient-level icons display with no color (gray/white) if unpopulated
• Populated icons display with a color (red, orange, brown) or other markings (border/outline)
Note: Many actions may also be executed from a hyperlink or menu tab in addition to the applicable icon.
Standard Workflow Overview: The Patient Chart
Patient Search ( )
*Admin Properties Search - Patient Registration
• Initially loads the encounter screen for the patient, displaying the current/most recent encounter or Face Sheet Encounter as applicable and adds the Current Encounter^ icon to the system tray.
• All other options under the Patient tab will default to that selected patient in temporary memory.
^ icon appears in system tray to the
return to encounter
• This screen is customizable to enable other patient-level criteria by which to search. The standard search (as shown) is the default view; the Case Management search is the alternative*.
Patient Register
Chart # unique to each patient
• Maintains the patient’s demographics* (e.g.: address, phone, email, employer, emergency contact, meaningful use details, other care providers) and financial summary, attorney, etc. as applicable.
*Admin Properties Patient Registration
Patient Insurance ( / )
Settings Configuration Vendors Insurance
Authorization at the payer level
Valid Coverage at the payer level
Benefits at the payer level by Date
Standard Workflow Overview Front Office
Appointments Schedule
Call List options
Date selector
Patient-focused details
*Admin Properties Appointment Scheduling
• System-level preferences determine the default display & functional options of the calendar*, which can be modified throughout the session at user level.
Search for Appointments
Taking an Appointment • Select an existing patient or a create a new patient via Quick Register option^
*Admin Properties Appointment Scheduling
The “Big 4”
• 3 ways to take an appointment, all of which open the Appointment Schedule dialog Note: The behavior of this dialog varies as to the “Big 4” – Date, Time, Provider, & Location.^ • Double-click available time slot on current calendar view (all 4 values auto-populate correctly) • Add New Appointment icon (defaults to 00:00 for current date, selected doctor/location) • Take Appointment system icon (defaults to 00:00 for current date for the patient/doctor of the
currently selected encounter at the 1st alphabetical location in the master file) • Enter the visit details; i.e.: Encounter Type (which defaults the Duration) and the Reason for the Visit
Existing Patients
^Quick Register
Visit Details
• Select to Overload a time slot, Wait List a patient, or force Anytime even if Provider is not available
Modifying an Appointment • Double-click the appointment to modify it, which will open the Appointment Schedule dialog.
Note: Any detail can be modified other than the patient name until the appointment is marked arrived. Once arrived, the appointment becomes an encounter & can only be modified at encounter level.
The cancel button does not cancel the appointment.
Working with an Appointment
• Status – displays the current routing status for the appointment in real-time.
• – lets user mark the appointment as Arrived with a single click.
• – lets user assign a routing status as well as assign treatment room and add remark. This feature is also available on Home Page & on Encounter screen. Note: Change status to Cancelled by Clinic or Cancelled by Patient to cancel an appointment, which will remove the appointment from the calendar but mark it in Appointment History.
• Name hyperlink – opens Patient Register, which provides access to the patient’s demographics.
• Single-click the appointment on the calendar (will outline it in red) to select it
• – provides direct access to patient Alerts, Notes, Billing Notes, Lab & Radiology Orders, Portal Login, Insurance, Encounter, Eligibility, & Legal Documents
• – copies the appointment to computer clipboard so it can be pasted elsewhere. Note: The appointment will display with a neon green background until pasted.
• The Patient Info Pane in the lower left will populate with action icons for that patient/appointment.
Cut/Paste to Move
Collection Time-of-Service Payments • – displays once the appointment is marked as Arrived, which allows
the user to enter a patient payment at the time of service applicable for that visit as well as any outstanding patient balance due or advance.
• Apportion To fields are applicable for EOB reconciliation only for PM users • Ins Copay or Deductible is per the insurance for today’s EHR visit only • Self Pay is for today’s EHR visit when there is no insurance applicable • Advance is for future services not covered by insurance • Outstanding Balance is for balance after insurance or Self Pay as reflec
Applicable only for PM users
Print walk-out receipt for patient.
ted in the patient bucket.
Notes: • The system auto-generates a Patient Receipt that must be adjudicated in Practice Management. • Only one walkout receipt is required and can reflect both EHR and PM payments even if the EHR
staff does not have access to PM.
Standard Workflow Overview Clinical Documentation
Patient Encounter • Multiple search options available apart from system search icon • Access patient level details for a specific visit or overall clinic history • Customizable TOC menu & face sheets*
*Encounter TOC options
*Admin Properties Facesheet Settings + Encounter TOC Parameters
Multiple Face Sheets*
Search options
History of Visits
Color Coding on Encounter Screen • Patient Band
• Light Blue = open encounter for the date displayed; all details subject to documentation* • Dark Gray = closed encounter for the date displayed; read-only data cannot be modified • Tan = face-sheet encounter, which allows history details to be updated or viewed as needed
*Admin Properties Encounters encounter.max.open
• Face Sheet Standards • Yellow = carried forward; data was previously known & entered directly into the face sheet • Green = new information received as of this encounter date & entered directly into the face sheet • White = not populated yet; data may be template-driven or entered directly into the face sheet • Gray = read-only data tagged from elsewhere in the database & displayed on the face sheet
Patient Intake • Review/update patient’s medical history, including medications, allergies, and problem list, etc.
Note: Select the Check All box to get credit without individually viewing each individual cell.
Input Templates
Patient History
*Patient Forms are applicable primarily when using the Patient Portal.
• Enter patient’s Vitals and HPI (Chief Complaints) and accept Patient Forms* if applicable.
Patient Forms (optional) • The Patient Forms may be completed by patient on-line from Patient Portal in advance of the visit • Once the form is Accepted by the user during Intake, the details are reflected on the face sheet
and/or encounter templates accordingly
Data must be Accepted into the Encounter
Templates Overview
• Input templates follow a hierarchy similar to that of a book – i.e.: Systems (chapters) are composed of Elements (words/sentences); those are compiled into Templates (books). The Sequence of the words/sentences determines the readable output.
• Clinic Forms do not require an encounter and may be in Open or Closed status for the patient. Multiple occurrences of the same form are acceptable.
• Specialty input templates are also known as Procedure Templates and can have a default output from (Op Note) in addition to or instead of a Progress Note.
• Default templates may be assigned at the Encounter Type or Complaint levels. • Default templates may be overridden at the encounter level via the or . • Local preference may enable auto-copy/pre-populate features at the template level*.
*Admin Properties Applicable Test Fields + Applicable Tests Checked
• Please note that although templates included with your library are specialty-specific, they may have to be tweaked per local use, preferences, and semantics.
• Output templates remain independent even when associated to an input template. • The underlying format of the Elements on your input templates determine the
content and format of the output documents (e.g.: Progress Note, Op Note). • In multi-provider clinics, each provider may have personal templates.
Output Templates
Input Template Conventions • The Result Type of each Element dictates the user intervention when completing the template;
i.e.: pre-defined multiple choice, tagged data from elsewhere in the chart, free-text, numeric only, date, system-calculated formulas, master file search, etc.
• Color-coding and or icon presence/absence determines data entry and the behavior allowed
• Yellow field indicates the data is being tagged from elsewhere in the chart; no data entry
• Gray field indicates the icon must be used to select from a pre-defined set of values; no data entry
• Single-select from multiple choice • Multi-select from multiple choice • Multi-select + data entry hybrid • Must select one or the other
• - indicates conditionally-based additional questions are relevant only when applicable
• White field w/no icon indicates limited free-text, data entry up to 250 characters
• White field with icon indicates free-text, data entry up to 5,000 characters
• Accessed from the Encounter TOC menu or from Face Sheet (local configuration preference*) • All templates include an unlimited Notes section at the bottom for each category • Macros/Smart Text narratives may be pre-defined for all Notes fields in the Phrases master
*Admin Properties Facesheet Layout # cell mapping
Output Template Conventions • The content that displays on any output is contingent upon the mapping of the applicable tags
(HTML, PrognoCIS) on the template design in conjunction with the Report Sentence syntax for each individual element/bullet contained within the applicable input template.
The literal sequence in which the tags are defined in the design
of the template mirrors the data flow on the actual output.
Labels/data outside of the HTML brackets [ ] will appear in output exactly as defined in the design of
the template. Be sure to spell correctly.
Formatting may also be defined, such as font style (bold, italics, underlined) or color, etc..
• Output may also be hard-coded based on local needs and scenarios in conjunction with the system-generated output.
Evaluation & Management • E&M – a CPT code that defines the level of service rendered for the office visit encounter, which
is based upon the time spent as well as medical decision making factors of the exam. • Actual row – displays the currently-saved values on the face sheet and input templates for the visit.
• MDM picklist – displays the currently-saved values on the face sheet and input templates for the visit.
Note: The E&M Tool is not a coding macro; however, it allows the user to compare the requirements for each E&M Level in comparison to what is actually documented on the visit. Based on this,
the system will prompt what action the user must take to qualify for a higher Level.
Assessment, and Plan* • ICD tab – reflects the ICD code(s) & corresponding Assessment & Plan of Care narratives for the visit
• CPT/HCPC tab – reflects the applicable treatment codes that explain the treatment rendered. Note: These values may pre-populate based on template configuration or be manually selected.
• Goal tab – reflects diagnosis-specific goals the provider has assigned within the Plan of Care
• Notes tab – allows the user to dictate narratives as regards assessment, plan, and procedures
Growth Chart • Interacts with child’s Vitals as applicable • Includes industry-standard, gender-specific CDC & WHO charts
Clinic Forms • Patient-specific specialty templates independent of or in association with one or more encounters • Worksheet for activities that do not require a Progress Note (e.g.: Pre-Cert, Surgery Scheduling, etc.) • A Zoom link ( ) to the Clinic Form is included with the System Notification in user’s Inbox
Supported Event #75 applies
Standard Workflow Overview Back Office
Searching for Results • Lab/Radiology Order – lists all tests that have been entered up until a result is
posted to it. Valid statuses are E, A, O (Entered/Approved/Ordered). Note: This screen tracks the order only – not the result.
• Lab/Radiology Results – lists all tests that have been Ordered (status O), including those with a result posted, pending results, pending review, or complete. Valid statuses are R, C (Results Received/Completed). Notes: Local preference may include status A (Approved) also*. Use this screen when patients are inquiring about their results being received yet.
• Lab/Radiology Review – lists all results that have posted and not yet been reviewed by the provider. Note: These entries correspond to a provider’s Home Page Review Bubbles.
Lab & Radiology behave the same
*Admin Properties Lab Parameters cpoe.labresults.forapproved Radiology cpoe.radresults.forapproved
Messages Attach / Scan* • Attach – contains all documents that have been locally scanned (within your
clinic) or received (via fax into your computer) to be categorized by document type and attached to the patient’s Document List. Note: This is not a direct-attach; hence, there is a delay in being able to access the document at the chart level from when it is initially scanned/received.)
• Scan – this option allows the user to scan a document or image directly to a patient chart in real-time (unlike the Attach Center). This feature also allows you to attach an external document into PrognoCIS from your pc/server.
Letters, Referrals, & Medical Record Requests • Allows you to correspond by fax, by email (secured or non-secured) or print referrals, letters, and
other correspondence or requests • Pre-defined templates or ad-hoc letters; ability to attach from Document List as needed
Transmission options
MU Core Objective
Document List
Resources and Support
Using the New Release Shortcut
Login as a valid user to your database
Click the New icon ( ), which remains visible for 30 days following an upgrade
The version-specific Release Notes will launch by default in a separate window
If there are technical difficulties with accessing or viewing the Release Notes, please contact Technical Support at (880) 552-3301, or (408) 873-3032, PST
Version Build Release Notes
Using the Help Topics
Login as a valid user to your database
Access the System Help icon ( )
Click Release Notes
Select the applicable version (Help
retains all version Release Notes)
Resource Center (cont’d)
Home Page a Resource Center
Launches Video Library
Videos by Module include topics that match the menu tabs
and module names within the application
Vides by Workflow lists topics based upon role in the clinic
(which may also exist under the “by Module” column)
Webinar Videos are recorded versions of public webinars and
have not been edited as the training videos have been
Resource Center
Home Page a Resource Center
Self-log Cases
Support Teams by eMail: • Technical Support: [email protected] • Meaningful Use: [email protected] • Training: [email protected] • Sales/Marketing: [email protected] • Accounting: [email protected]
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Public webinars
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