B. WORKING WITH SCHEDULES Daily Schedule Clinical Toolbar Personalize Multiple Provider Schedules...8

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1 A. OVERVIEW OF JUP EMR Logging in and Logging out Vertical Toolbar Horizontal Toolbar Site Selector VTB Locking the Session Toolplace...5 B. WORKING WITH SCHEDULES Daily Schedule Clinical Toolbar Personalize Multiple Provider Schedules...8 C. WORKING WITH PATIENTS Selecting a Patient on the Schedule Patient Profile Appointment Details Patient Appointments Searching for a Patient...11 D. CLINICAL DESKTOP Problem Visit Summary Meds/Orders Allergies Health Management Plan Chart Viewer Component Patient Worklist...19 Page 1 of 20

2 A. OVERVIEW OF JUP EMR 1. Logging in and Logging out The JUP EMR shares the same web framework as the IDX Flowcast practice management system. The EMR can be easily accessed from any practice desktop, by double-clicking on the empower icon: Alternately, there is a link on the Pulse homepage and the TJUH Clinician page. The URL address is: a. To login, type the username in lower case in the Login ID text box and then <Tab>. b. Type the password in lowercase In the Password text box. c. Use the mouse to click the New Session button or press the <Enter> key. Page 2 of 20

3 To exit the system, click the X Logoff button located on the top right side of the screen. The following box will appear. Click <OK> to end the session. 2. Vertical Toolbar Upon logging into JUP EMR, a vertical toolbar (VTB) displays on the left side of the screen. The four standard VTB options for viewing the EMR are: a. CHART: contains Provider Schedules, Appointments and the Clinical Desktop b. SITE: lists the user s default practice location c. JEFFWEB: links to Jeff Mail, Jeff Cal and Pulse d. READ IDX IDX If you already have access to the IDX practice management system, the Chart and Site options will be added to the existing VTB. 3. Horizontal Toolbar A horizontal toolbar (HTB) displays along the top of the screen after a vertical toolbar (VTB) option is selected. Page 3 of 20

4 Chart displays four HTB tabs: a. Daily displays one provider s schedule. b. Provider Schedules displays up to four providers schedules. c. Appointments displays an appointment list for one patient. d. Clinical Desktop displays information from the patient s chart including scanned documents, hospital lab results, imaging reports, problems, allergies and medications. 4. Site Selector VTB The Site VTB may need to be utilized if a user works in more than one practice location. The site controls the printer for requisition slips and prescriptions. Page 4 of 20

5 The button allows the user to change the defaulted location from the Site Selector page. Double-click the appropriate site location and the new location displays on the Site page. 5. Locking the Session The button located at the top of the window, pauses the current session. It allows the user to quickly clear the screen, which can be important for patient confidentiality. From any page, click the Lock button. The Session Locked page displays. To resume work in JUP EMR, enter the password in the Password box and then click the Resume button. 6. Toolplace The drop-down at the top of the window contains Settings and the Show/Hide Clinical Toolbar option. a. Settings include the User Preferences and Change Password HTBs. b. User Preferences allows the user to create defaults for the following information: Page 5 of 20

6 c. The Change Password screen allows the user to change the current password: d. The Show/Hide Clinical Toolbar allows the user to toggle between displaying and removing the floating Clinical Toolbar that appears whenever a user accesses the Chart VTB. B. WORKING WITH SCHEDULES 1. Daily Schedule The Daily screen is the default after selecting Chart and it displays one provider s schedule. A Provider can be selected from the drop-down box or the button can be used to search for a Provider who does not appear in the list. The date can be changed with the calendar icon or by clicking on the days of the week. The appointment status, patient location, appointment time, patient name, appointment type, appointment duration and appointment comment all appear on the screen. Page 6 of 20

7 In addition, to the appointment information, the schedule also contains these columns: After a charge has been submitted for the visit, a dollar sign appears in this column. Once a note has been created for the visit, a paper icon appears in this column. If the note was signed, a check mark appears in the paper icon. This column shows the status of the visit from the IDX system (pending, arrived, no show, cancelled or bumped note: rescheduled is the same as pending). 2. Clinical Toolbar The Clinical Toolbar displays as a floating toolbar until the Clinical Desktop is accessed; it is then docked at the top of the page. Two important drop-downs appear to indicate the location and status of the patient within the practice: Patient Location Enables users to track the patient s current location throughout the course of the visit. For example, Room 303. Status Enables users to assign and track the patient s current status throughout the course of the visit. For example, Provider Ready. Page 7 of 20

8 3. Personalize The Personalize link located on the right side of the screen, opens a dialog box so that you can set preferences for both the daily and multiple provider schedules. The default for the Schedule Content is Arrived, Pending and Rescheduled appointments. This can be changed so that a user can view all appointments. 4. Multiple Provider Schedules The Provider Schedules page can display 4 providers schedules simultaneously. Page 8 of 20

9 C. WORKING WITH PATIENTS 1. Selecting a Patient on the Schedule A patient can be selected by a single-click on the patient s name. Once the patient is selected, the patient s information displays in the Patient Banner. After selecting a patient, the following actions can be accessed from the bottom of the screen to view patient demographics and appointment information. 2. Patient Profile The Patient Profile dialog box contains demographic and pharmacy information. To access it, the user can click on the action code at the bottom of the screen or click the i icon in the Patient Banner. The Patient Profile dialog box has the following sections: a. FYI this is a free text field to be used for basic information about the patient. For example, patient s son just returned from a tour of duty in Iraq. No clinical or financial information should be placed in this box. b. Chart Alerts this is a dictionary and ad hoc space which is the equivalent of a red underlined note on the front of a paper chart. For example, patient has a latex allergy. Page 9 of 20

10 Ad Hoc Chart Alerts should only be entered by the clinical staff. Patients can have up to three Chart Alerts visible on the Clinical Desktop. c. Demographics/Employer/Insurance these sections contain data from the IDX system. d. PBM / Pharmacy this section contains the Pharmacy Benefit Manager information from Rx Hub which provides eligibility, formulary, benefits and medication history for consenting patients, to authorized physicians at the point of care. The patient s retail and mail order pharmacies are also listed in this section. Up to three pharmacies can be entered for the selected patient. When prescribing in JUP EMR, these pharmacies will be available. The most recently selected pharmacy is the default value. 3. Appointment Details Appt Details opens a dialog box that displays information from IDX about the visit: 4. Patient Appointments Patient Appts opens a dialog box that displays a list of all IDX visits: Page 10 of 20

11 5. Searching for a Patient A patient who is not on the schedule can be selected from the Select Patient drop-down menu, select Search. The Select Patient page displays so that the user can enter the search criteria and select a patient. Listed below are some of the methods that can be used to retrieve a patient at any Name or Patient prompt throughout the system. In the Patient field, fill in the correct information and at the Name prompt choose the corresponding Search, then click on the search button. These are the available searches: Name Date of Birth Medical Record Number Phone # Social Security # Page 11 of 20

12 D. CLINICAL DESKTOP To access the Clinical Desktop, double-click on the patient displayed on the schedule. The Clinical desktop contains the patient s electronic medical record. It is divided into sections called components. User security determines the actions that can be accessed in each component. After completing this course, a user will be able to view detailed information and print from each component, but not edit the chart. The default view is the Adult Patient View, which has the 7 components listed below: Problem Visit Summary Meds/Orders Allergies Health Management Plan Chart Viewer Patient Worklist If the patient is a child, the view can be changed to the Pediatric Patient View which has one additional component called Immunizations. Working within Components From each component on the Clinical Desktop, the user has the ability to view and/or print information. To access information within a component, the user can do the following: Page 12 of 20

13 a. Single-click to highlight an item and activate associated actions b. Double-click to display the details of the selected item within a separate window c. Right-click to display a menu of actions that may be used with the selected item Each component has a Print option, that when selected, opens a dialog box so that the user can select a device: The following table describes additional functionality within the Clinical Desktop components. Button Name Description Refresh Refreshes the information within the associated component. Tile/Full Screen Expand All New Task Toggles the Clinical Desktop between a tiled component view and a full screen component view. Expands/Collapses the items and associated information within a component. Displays the Task Details dialog enabling the user to create a new task from the associated component. Page 13 of 20

14 1. Problem The Problem component displays the patient s active problems. Problems are listed and grouped according to the selected View and Group By option. The problem name is listed, along with the corresponding ICD-9 code. Actions at the bottom of the component allow the user to view and print information. The following options are available when viewing this component: Views Actions Active Problems (default view) Past Medical History Past Surgical History Family History Social History View Print Problem List View: Group By: Actions 2. Visit Summary The Visit Summary displays historical information. The encounters are listed by date in reverse chronologic order. The encounter name is listed along with the date, provider and provider specialty. The following options are available when viewing this component: Views All by Date Page 14 of 20

15 All by Appointment Actions View View: Actions 3. Meds/Orders The Meds/Orders component displays the patient s medications and orders. The medications and orders are listed and grouped according to the selected View and Group By option. The item name is listed, along with some or all of the following (the + sign opens the description): formulary icon name dosage start date renew date patient instructions Views Current Meds/Orders Current Medications Current Orders Past Medications Past Meds/Orders All Meds/Orders Actions View Print Medication List Page 15 of 20

16 View: Group By: Actions The face icons to the left of each medication are the formulary status indicators: ICON - Green - Yellow - Red No indicator DESCRIPTION Indicates the medication is preferred by the insurance company. Indicates the medication is approved by the insurance company; a higher co-pay may be required. Indicates the medication is not approved by the insurance company. Indicates prior authorization for the medication is required by the insurance company. Indicates an over-the-counter medication, which is not covered by the insurance company. Indicates that no formulary information is available. 4. Allergies The Allergies component displays the patient s allergies.. Views Medications Non-Medications All Actions View Page 16 of 20

17 View: Group By: Actions 5. Health Management Plan The Health Management Plan component provides an overview of the patient s treatment plan. Views Health Management Reminders/Alerts Immunizations FlowSheets Vital Signs View: Group By:. Page 17 of 20

18 6. Chart Viewer Component The Chart Viewer displays notes, results, scanned documents and interfaced items. Views Encounter Owner Problem Provider Section Specialty Visit All by Owner by Encounter All by Problem by Encounter All by Section by Sub-Section All by Specialty by Encounter All Items All Notes All Results All Results by Encounter Actions View View in New Window Print View: Group By: Actions Page 18 of 20

19 To filter the Chart Viewer, click the filter icon. A Search field displays with a list of quick filter options. Use the drop-down arrows to narrow the list of chart items further. The Chart Viewer Print action displays the following menu: Chart prints the entire chart and will only be available to specific staff members Selected prints only the selected document SnapShot prints patient s active problem, medication and allergy lists Worksheet prints the patient s active problem, medication and allergy lists along with a list of the patient s results 7. Patient Worklist The Patient Worklist that appears on the Clinical Desktop is a patient-centric worklist (that is, a list of order or result-related items that apply to one specific patient). Providers and clinical staff may find it helpful to review a patient s worklist prior to a patient s appointment to review results or follow-up on outstanding orders. Not all users have access to the Worklist. The Views available to each user depend on the assigned role. Views Abnormal Results Abnormal Results Department Med Administration Normal Results Normal Results Department Orders Management Orders Management Department Page 19 of 20

20 Pre-Authorization Pre-Certification Result/Order Management Result/Order Management Department Results Abnormal Results Abnormal Department Results Normal Results Normal Department View: Page 20 of 20