Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Coaching Course

Transcription

1 IDEXX Cornerstone * Practice Management System Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Coaching Course Participant Workbook

2 Proprietary Rights Notice Information in this document is subject to change without notice. Companies, names and data used in examples are fictitious unless otherwise noted. No part of this document may be reproduced or transmitted in any form or by any means, electronic, mechanical or otherwise, for any purpose, without the express written permission of IDEXX Laboratories. IDEXX Laboratories may have patents or pending patent applications, trademarks, copyrights or other intellectual or industrial property rights covering this document or subject matter in this document. The furnishing of this document does not give a license to these property rights except as expressly provided in any written license agreement from IDEXX Laboratories IDEXX Laboratories, Inc. All rights reserved Cornerstone*, Patient Clipboard* and SmartLink are trademarks or registered trademarks of IDEXX Laboratories, Inc. or its affiliates in the United States and/or other countries. Microsoft, Windows and Windows Server are trademarks or registered trademarks of Microsoft Corporation in the United States and/or other countries. Epson is registered trademark of the Seiko Epson Corporation. Adobe and Reader are either registered trademarks or trademarks of Adobe System Incorporated in the United States and/or other countries. DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digital communication of medical information. Accelerated Payment Technologies and X-Charge are trademarks or registered trademarks of Accelerated Payment Technologies, Inc. Topaz, ClipGem and SigLite are trademarks of Topaz Systems, Inc. in the U.S. and/or other countries. All other product and company names and logos are trademarks of their respective holders. Published by IDEXX Laboratories, Inc. IDEXX Computer Systems Eau Claire, Wisconsin 54703, USA idexxcornerstone.com Printed in the United States of America. CS81_EMRWBS_ _REV04

3 IDEXX Cornerstone 8.1 Electronic Medical Records (EMR) & Whiteboard Setup Table of Contents Before You Begin Introduction to the Electronic Medical Records (EMR) & Whiteboard Setup Coaching Course...6 Workflow Overviews Chapter 1: Patient Visit Overview...9 Patient Workflow Overview R M...10 Technology Introduction...12 Electronic Medical Records Setup Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Chapter 1: Electronic Medical Records Default Settings...15 Security Settings Guide Overview...16 Default Settings Guide...17 Chapter 2: Reason for Visit Alerts & Documents...34 Reason for Visit M...35 Customizing the Scheduled Visits Display M...36 Chapter 3: User Defined Prompts - Client and Patient...37 Setting User Defined Prompts for Clients & Patients...38 Chapter 4: Medical Note Strategy...41 Medical Record Strategy...42 Chapter 5: Invoice Item Setup M...44 Invoice Item Setup Basics M...45 Creating Pick Items M...47 Creating Dispensing Items M...48 Link a Dispensing Item to an Invoice Item M...49 Creating Smart Groups M...49 Copying a Group to Another Group M...51 Invoice Items to Generate and Satisfy Reminders M...52 Setting up Vaccine Information...53 Special Actions...55 Chapter 6: Vital Signs Setup M...57 Vital Signs Overview M...58 Vital Signs Type M...59 Quick Start Steps M...61 Setting Up and Activating the Vital Sign List for Your Practice M...62 Editing the Weight Vital Sign M...63 Vital Sign Bookmarks M...63 Check-In Report Print Options M...63 Deleting a Vital Sign M...64 Other Procedural Steps...64 Chapter 7: Electronic Whiteboard Setup M M...67 Customization Recommendations M...68 Memorized Patient Orders M...71 Defaults and Security M...72 Other Procedural Steps...75 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Table of Contents Page 3

4 Table of Contents Chapter 8: Physical Exam Setup...77 Physical Exam Defaults M System Templates M Systems M Observations M Chapter 9: Medical Notes & Correspondence M...83 Document Template Overview M...84 Windows and Features For Creating Document Templates M...85 Template Properties and Save Options M...87 Other Procedural Steps...88 Appendix Add a Group for Monitoring Patients Who are on the Electronic Whiteboard...95 Patient Visit Workflow...97 Project Plan Template...98 Sample Project Plan...99 IDEXX Cornerstone Chartless Setup Checklist Follow-Up and Next Steps Electronic Medical Records & Whiteboard Setup Coaching Course Skill Assessment Electronic Medical Records & Whiteboard Setup Coaching Course Evaluation Page 4 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Table of Contents

5 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup EMR Setup: Section 1 Before You Begin Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Before You Begin Page 5

6 Introduction to the Course Introduction to the Electronic Medical Records (EMR) & Whiteboard Setup Coaching Course Course Description This course is ideal for individuals responsible for the setup of electronic medical records and/or the Electronic Whiteboard. You ll learn of electronic medical records and whiteboard as well as other related setup tasks such as: Patient Visit Overview Electronic Medical Records Default Settings Invoice Item Setup Electronic Whiteboard Setup Medical Notes and Correspondence Vital Sign Setup Prerequisites 1. Cornerstone 8.1 installed at practice. 2. Basic Cornerstone navigation. 3. Attendees with security access to: Defaults - Practice Invoice Item List Prescription Instruction Setup Defaults - Staff Physical Exam - Problem Categories List Observation Setup Defaults - Workstation Physical Exam - Subsystem Setup Departing Instruction List Physical Exam - System Setup Departing Instruction Setup Document Template List Document Template Setup Invoice Item Information Physical Exam - System Template Patient Hospital Status List Patient Hospital Status Information Prescription Instruction List Problem Category Information Problem List Problem List Information Reason for Visit Setup User Defined Prompt Setup User Defined Prompts Ward/Loc Information Ward/Loc List Whiteboard Whiteboard Area Information Whiteboard Area List Whiteboard Category Information Whiteboard Category List Whiteboard Frequency Information Whiteboard Frequency List 4. Can create and attach departing instructions and prescription instructions. 5. Client Account: Practice Account or Employee Account with Pets. Getting Started Throughout this training tool, you will be working in your live Cornerstone database, which will allow you to complete feature setup during the course. As you use this tool, it is most effective if you are working at a Cornerstone workstation so that you can follow along in the training guide and complete the demonstrations and practice exercises using Cornerstone on your computer. Training Content Content of the training includes four sections: Section 1: Before You Begin Section 2: Workflow Overviews Section 3: Electronic Medical Record Setup Section 4: Appendix Page 6 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Introduction to the Course

7 To Complete Your Training Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup 1. Practical Application: Demonstrations and practice exercises provide the opportunity for practical application of patient visit basics. Trainer-Led Demonstrations provide specific instructions and tasks for you to complete in the Cornerstone Training Files. These demonstrations provide a hands on training activity. [ ] Use the information in the brackets for Cornerstone data entry. Trainer-Led Explanations provide an explanation of the concepts. Important Information lists to important information; read this information carefully. Practice Exercises reinforce and confirm your skills with patient visit basics. Learners use the client they set up during the Trainer-Led demonstrations to complete the tasks listed. The practice exercises follow a scenario much like the one completed during the Trainer-Led demonstrations but not in a step-by-step format. When you see this image placed below a lesson name, it indicates that Snippets are available online at for topics related to this lesson. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Introduction to the Course Page 7

8 EMR Setup: Section 2 Workflow Overviews Page 8 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Workflow Overviews

9 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Chapter 1: Patient Visit Overview You ll learn these important concepts within this chapter: Patient Workflow Overview Gain knowledge of the steps in the Cornerstone workflow. Technology Introduction Recognize technology that will be useful for a chartless practice. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Patient Visit Overview Page 9

10 Chapter 1: Patient Visit Overview Patient Workflow Overview R M The diagram on the next page illustrates the IDEXX Cornerstone training workflow. This workflow has eight components: Step 1 - Check-In Step 2 - Exam Step 3 - Charge & Procedure Verification Step 4 - Recommended Procedures and Costs Step 5 - Admit & Procedures Step 6 - Procedures Step 7 - Post Procedures Step 8 - Final Step - Check Out Page 10 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Patient Visit Overview

11 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Patient Visit Workflow Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Patient Visit Overview Page 11

12 Chapter 1: Patient Visit Overview Technology Introduction IDEXX SmartLink technology allows a practice to make a diagnostic request from Cornerstone or IDEXX equipment while at the same time charging the client, with the request automatically submitted to the lab or imaging diagnostic equipment without reentering the client and patient information. Following, the results are transferred back to Cornerstone into the patient file. SmartLink Integration Advantages SmartLink Integration offers superior advantages of captured missed charges and improved efficiencies, including the reduction of client and patient ID errors. Review the following simplistic workflows. IDEXX SmartLink In-house Laboratory Enter in-house laboratory request in Cornerstone and the client is billed. Lab request and information automatically transfers to analyzer. Results are downloaded into Cornerstone patient history. IDEXX SmartLink Reference Laboratories Enter reference lab requests in Cornerstone and the client is billed. Lab request and information is printed on a LabREXX form and sent with sample. Results are downloaded into Cornerstone patient history. IDEXX SmartLink Digital Imaging Enter imaging request in Cornerstone and the client is billed, Imaging request and information automatically transfers to IDEXX digital imaging equipment. Results are downloaded into Cornerstone patient history. Page 12 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Patient Visit Overview

13 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Signature Capture Device If your practice has an approved signature capture device, you can immediately have a client electronically sign a correspondence document or estimate. An approved signature capture device is purchased separately. Signature bookmarks must be added to correspondence documents in order to add client signatures to documents. Speciality Printers Pet Detect Printer A simple, affordable and professional solution to every practice s animal identification needs. This collar printer allows access to the name, cage name, medical information and other critical data. Zebra P110; ID Card Printer Use the printer with existing templates in Cornerstone to print patient ID cards. The P110; delivers consistent, high quality printing and trusted dependability. The sleek design uses high strength plastics and advanced electronics for reduced size and weight with outstanding performance. Scanners Document scanners can be used to add items that cannot be downloaded or attached electronically into the patient s file. Examples: lab results from universities, emergency or referral reports, new client registration forms. Whiteboard Monitor A large LCD monitor on the wall in the treatment area will allow the Whiteboard to be very visible to your staff and ensure they are keeping up with patient treatments. Barcode Readers Handheld barcode scanners allows user to scan item for inventory management and at point-of-sale. DICOM Importing 3rd Party Imaging Import DICOM images into the Cornerstone database for easy viewing on any Cornerstone workstation. Once the iamge is in the Cornerstone database, access is available to all features available within the IDEXX PACS software including telemedicine. Benefits include the need for only one storage and back-up solution versus maintaining separate networks, databases and back-ups. Images are stored in the patient s electronic record. Chapter Summary You learned these important concepts within this chapter: Patient Workflow Overview Gain knowledge of the steps in the Cornerstone workflow. Technology Introduction Recognize technology that will be useful for a chartless practice. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Patient Visit Overview Page 13

14 EMR Setup: Section 3 Electronic Medical Records Setup Page 14 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

15 Chapter 1: Electronic Medical Records Default Settings You ll learn these important concepts within this chapter: Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Security Settings Guide Overview Gain knowledge of Security Settings. Default Settings Guide Overview Successfully access defaults for the electronic medical record and electronic whiteboard. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings Page 15

16 Chapter 1: Electronic Medical Records Default Settings Security Settings Guide Overview Creating a secure environment for your electronic medical records is extremely important. As you move through the set up process it is extremely important that you look more deeply into your security to prevent data compromises. Discussion Question: 1. Where do I locate the Security Settings Document? 2. How do I find out about updates or changes to security? 3. Why is security so important? 4. What is an example of a setup area related to EMR that may be compromised if security is not properly managed? Page 16 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings

17 Chapter 1: Electronic Medical Records Default Settings Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Default Settings Guide Instructions: This document outlines the defaults that must be addressed, and in the order which they must be addressed, once the database is loaded. The defaults are located on the Cornerstone Lists and Controls menus. Use this document to make database decisions prior to establishing default settings. To complete the information listed in this guide, a staff person must be set up and proper security access must be granted. Practice and Workstation Defaults Window This window simplifies your initial Cornerstone setup and saves you time when looking for a particular default setting. Accessing Practice and Workstation Defaults 1. Select Controls > Defaults > Practice and Workstation. 2. The left side navigation pane lists the available properties that you can configure. A plus sign [+]box to the left of a property indicates that it has one or more associated sub properties; click the [+] box (or the property) to expand its list of sub properties. Select the property or subproperty to configure. The corresponding configuration pane displays on the right. 3. Depending on your actions, the following buttons may display on the bottom of the Practice and Workstation Defaults windows: Apply Applies any changes made since the last time Apply was clicked and leaves the Practice and Workstation Defaults window open so you can continue viewing/changing additional properties as needed. OK Applies any changes and closes the Practice and Workstation Defaults window. Cancel If any changes have been made, it asks if you want to save the changes, and then closes the Practice and Workstation Defaults window. (Any previous changes that were applied using the Apply button are retained, not cancelled.) Close Closes the Practice and Workstation Defaults window (displays in place of the Cancel button if no changes have been made or if changes have been applied). Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings Page 17

18 Chapter 1: Electronic Medical Records Default Settings EMR Default Settings Guide Discussion Question: 1. Where do I locate the Default Settings Guide? 2. How do I find out about updates or changes to defaults? 3. How will changes affect the appearance of my past records? Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Action & Decision Practice See Fig. BB Health Certificate Select a document to use as your default Health certificate document. This document must be set up in Client Correspondence to set it as the default. Fig. BB (Controls > Defaults > Practice and Workstation > Practice property) Sel Page 18 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings

19 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Action & Decision Practice Logo To set up a practice logo (basic steps): 1. Specify the graphic file for the logo in Practice defaults (Controls > Defaults > Practice and Workstation, and then select Practice in the navigation pane on the left). Supported graphic file types include BMP, GIF, JPG and JPEG. 2. If you want the practice logo to print on estimates, in Estimate Address defaults, select the Print practice logo on invoices check box and position the Practice Logo box as desired. If you want the practice logo to print on invoices, in Invoice Address defaults, select the Print practice logo on invoices check box and position the Practice Logo box as desired. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings Page 19

20 Chapter 1: Electronic Medical Records Default Settings Controls > Defaults > Practice and Workstation Menu Access Default Description Estimate See Fig. C Sel = Select Set = Setup Ver = Verify Staff ID Enter the Staff ID to appear on new estimates. Set Both finalized and tentative unfinalized estimates will remain in the system the number Number of Days to Sel of days selected and then will disappear. If an estimate is finalized and a patient visit store list is created, that list will not be removed until the items are either invoiced or deleted. This option is only a default setting when saving and can be overridden when saving an estimate. Finalize estimate Transfer Estimate prices to the Patient Visit List Select the Finalize estimate check box to default an estimate s status to final when saving estimates. When creating an estimate, you have the option of changing the selection of the finalize estimate check box. Finalizing an estimate means that no changes can be made to its contents. Finalizing also creates a patient visit list for the charges listed. Transfer to patient visit list Low prices Select to transfer the low prices from the estimate to the Patient Visit List. Transfer to patient visit list High prices Select to transfer the high prices from the estimate to the Patient Visit List. Add invoice items to PVL Setting allows you to set a practice-wide default specifying if invoice items should automatically be added to the Patient Visit List from a finalized estimate. Options include Always Ask, Always Add and Never Add. Action & Decision Sel Sel Page 20 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings

21 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Estimate See Fig. C (continued) Estimate Print Options # Copies Print Staff Name Print Item ID Enter the number of copies of the Estimate you want to print. This option is only a default setting when printing and can be overridden when printing an estimate. Select the Print staff name check box if you want to print the staff name on estimates. Select the Print item ID check box if you want to print invoice item IDs on estimates. Action & Decision Sel Use Authorizing Signature Use Witness Signature Preview before Printing Use authorizing signature if you want the option to have clients provide electronic signatures on estimates. Use witness signature allows you to capture an electronic witness signature and adds a Witness Signature line to the estimate. Preview before printing The Print Preview window for estimates allows you to complete many estimate processing tasks in a single window: View the estimate at different zoom levels Specify the number or days to keep an unsigned estimate (signed estimates are automatically finalized and saved to patient history) Finalize an estimate Print an estimate an estimate using Microsoft Outlook or Outlook Express Obtain an electronic signature and optional witness signature on an estimate (requires a connected signature capture device or a tablet PC) Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings Page 21

22 Chapter 1: Electronic Medical Records Default Settings Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Estimate See Fig. C (continued) Estimate Print Options Print prices Only low prices Print prices Only high prices Print prices Both low and high prices Print Both detail and total Print Only total You can select to print only the low prices on the estimate by clicking the desired selection. You can select to print only the high prices on the estimate by clicking the desired selection. You can select to print both high and low prices on the estimate by clicking the desired selection. You can select to print the estimate detail and total. You can select to print the estimate total only. Action & Decision Sel Estimate message Print estimate messages on separate page Setting a default message allows you to combine more than one estimate message as the default message to print on the estimate. It also gives you the option to have the estimate message print on a separate page from the estimate. Estimate messages can be changed as estimates are created. (Originates from: Controls > Estimate Messages). Selecting this option will print all estimate messages on a separate page from the invoice, usually following the last printed page of the invoice. Sel Sel Page 22 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings

23 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Action & Decision Fig. C (Controls > Defaults > Practice and Workstation > Estimate property) Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings Page 23

24 Chapter 1: Electronic Medical Records Default Settings Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Invoice See Fig. D Staff ID Invoice Type Type the Staff ID to appear by default on a new invoice. If you have multiple staff members it may be best not to default to a staff member. Not selecting a default Staff ID will require staff to choose the appropriate provider at the time of invoicing. Choose the Invoice Type to appear by default on a new invoice. Examples include: Office Appt Scheduled Office Appt Walk In Office Appt Emergency Over The Counter (OTC) Out of Office Appointment Prescription Only Tech Appoointment Emergency Surgery Grooming Boarding Action & Decision Sel Sel Display patient visit message Deselect the Display Patient Visit Message check box if you want the Patient Visit List to automatically appear when items exist on the Patient Visit List for any patient belonging to the client that you re invoicing. If this option is selected, a message will display, asking if you want to select items from the list. Sel Automatically mark patient as deceased Select Automatically Mark Patient As Deceased to automatically change a patient s status to Deceased when they are invoiced for an item with the Mark As Deceased special action. Sel Apply group item pricing before dispensing fee and minimum price Select the Apply group item pricing before dispensing fee check box if your practice gives discounts on invoice item groups and you want to exclude dispensing fees from the discount. This can be changed per item later if necessary. Sel Page 24 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings

25 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Invoice See Fig. D (continued) Prompt for call back note Select the Prompt for call back note check box if you want a call back note to display while invoicing. This option will allow staff to enter specific call back information at the time of invoicing so it is available to the staff making the call at a later time. The invoice item must be set to generate a call back reminder. Action & Decision Sel Display below reorder point warning Omit duplicate special action documents Deselect the Display Below Reorder Point Warning check box if you do not want an alert box to pop up when an item that is below the reorder point is placed on an invoice. Select the Omit duplicate special action documents check box to prevent duplicate documents from printing. Sel Sel Use controlled substance reasons Select the Use Controlled Substance Reason check box to allow the display of the Controlled Substance Reason Lists on invoices. Reasons are set up under the Controls menu and items must be marked as controlled substance for this feature to work. Sel Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings Page 25

26 Chapter 1: Electronic Medical Records Default Settings Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Action & Decision Invoice Print Options Calculate accounts receivable by provider Print heading Deselect the Print Heading check box if you do not want your practice information to appear at the top of invoices. (Originates from Lists > Practice) This is usually done if you are using letterhead or pre printed paper instead of plain paper for printing invoices or estimates. # copies Choose the number of copies you want to print of the invoice. Print staff name Print patient reminders Number of months to print appointments for Turn on invoice receipt options Select the Print staff name check box if you want the name of the provider name to appear on the invoice. The name will print as it displays in the staff list. Select the Print patient reminder check box if you want patient reminders to appear on the invoice. Print future appointments for active patients of clients on the bottom of invoices. Enter the desired number of months in the Number of months to print appointments for field. This option allows the user to print 3 1/8 receipts instead of full page invoices. The receipt does not include client information and does not list invoices items by patient. This option requires an Epson TM T88IV receipt printer. If you pay your providers based on collected accounts receivable, select the Calculate accounts receivable by provider check box. If you do not pay your providers this way, do not activate this option. Use this feature if: Are doctors paid by commission If yes, how much? Are doctors paid by production only? Are doctors paid by money received on production? The percentage the doctor earns on the money received on production. Sel Sel Page 26 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings

27 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Invoice See Fig. D (continued) Apply payment to specific invoices for A/R by provider Select the Apply payment to specific invoices for A/R by provider check box to always apply payments received to a specific invoice. We recommend that this box not be selected. Then, the payment on the invoice will be applied to the oldest balance first. Unless you selected the previous option (Calculate accounts receivable by staff), skip this option. You must select this option if you want to print an A/R report by provider as part of your End of Month. Action & Decision Sel Patient Visit List Patient visit list Include recommended Select the Include recommended check box if you want items with a recommended status to be automatically selected to transfer to an invoice and to be included in the total displayed on the PVL. Sel Patient visit list Include accepted Select the Include accepted check box if you want items with an accepted status to be automatically selected to transfer to an invoice and to be included in the total displayed on the PVL. Patient visit list Include performed Select the Include performed check box if you want items with a performed status to be automatically selected to transfer to an invoice and to be included in the total displayed on the PVL. Patient visit list Display blue comment line Select the Display blue comment line check box if you want the blue comment lines to appear on the patient visit list. Patient visit list Display duplicate items warning Deselect the Display duplicate items warning check box if you do not want this warning window to appear. The items will still show in a maroon color. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings Page 27

28 Chapter 1: Electronic Medical Records Default Settings Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Action & Decision Fig. D (Controls > Defaults > Practice and Workstation > Invoice property) Page 28 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings

29 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Menu Access Default Description Controls > Defaults > Staff > Toolbar tab Staff Defaults for Toolbar tab Fig. EE (Controls > Defaults > Practice and Workstation > Toolbar property) Sel = Select Set = Setup Ver = Verify In the Staff field, enter a staff ID, select or deselect the check boxes of the icons you want to display on the Cornerstone window. Using the feature will allow a practice administrator to determine, based on Staff ID or Log in, what icons are shown. Action & Decision Set Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings Page 29

30 Chapter 1: Electronic Medical Records Default Settings Menu Access Default Description Controls > Defaults > Staff > Miscellaneous tab Staff Defaults for Miscellaneous tab Login page Revenue center Appointment suite Display backup log when logging in Imaging Sel = Select Set = Setup Ver = Verify From the staff person displayed in the Staff field, select a default log in page. For the staff person displayed in the Staff field, select a default Revenue center. For the staff person displayed in the Staff field, select a default Appointment suite. Select the Display backup log when logging in check box if you want to display the backup log when the selected staff person logs in. For the staff person displayed in the Staff field, select if keyboard shortcuts should be enabled and if advanced search on the Image Explorer should show. If checked, the Image Explorer will default into the Advanced search when opened. Update image and tell what happens as result of checking this checkbox. Enable keyboard shortcuts Show advanced search on Image Explorer Action & Decision Set Controls > Defaults > Staff > Inventory This information is for practices that use multiple inventory locations. Staff Defaults for Inventory tab Inventory location group Allows each login to choose to default Inventory Location Group to deplete inventory from. If you assign a location group, they need to assign which location within the group the staff member will deplete the inventory items from. Allows each individual login to choose a default location to deplete inventory from. Auto save changes without prompting setting should be used (checked) with caution. If you check this box you will NOT be able to confirm changes you make within Cornerstone inventory. It is recommended you leave this box unchecked. Auto delete changes without prompting setting should be used with caution. If you check this box you will NOT be able to confirm changes you make within Cornerstone Inventory. It is recommended you leave this box unchecked. Set Location Auto save changes without prompting Auto delete changes without prompting Page 30 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings

31 Menu Access Default Description Controls > Defaults > Staff > My Favorites Controls > Defaults > Staff > Patient Clipboard tab Controls > Defaults > Staff > Toolbar tab Staff Defaults for My Favorites tab Staff Defaults for Patient Clipboard tab Staff Defaults for Toolbar tab Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Sel = Select Set = Setup Ver = Verify Type the document ID of the Medical Note or Correspondence documents you would like to include on your Favorites list. (Lists > Documents > Templates). In the Staff field, enter a Staff ID, select or deselect the check boxes of the icons you want to display on the Client or Patients information areas of the Patient Clipboard. Use the arrows to the right of each list to change the display order of the icons. Using this feature will allow a practice administrator to determine, based on Staff ID or Log in what is show on the Patient clipboard in the Client and Patient information tabs. Click the Reset Defaults button to reset the display defaults. In the Staff field, enter a staff ID, select or deselect the check boxes of the icons you want to display on the Cornerstone window. Using the feature will allow a practice administrator to determine, based on Staff ID or Log in, what icons are shown. Action & Decision Set Set Set Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings Page 31

32 Chapter 1: Electronic Medical Records Default Settings Sel = Select Set = Setup Ver = Verify Menu Access Description Action & Decision Controls > Problems > Problem Categories Cornerstone allows the user to set up categories that can be linked to problems in order to organize the list of problems. Example: Categories: Gastrointestinal Problems: Abdominal Pain Acute Vomiting Anorexia Chronic Vomiting Constipation Controls > Problems > Problem List Cornerstone provides a list of problems that can be selected as the presenting problem for a particular visit or used to track problems for the patient long term. Additions and corrections to this list can be made as needed. Ver Used throughout Cornerstone in the following manner: Used to enter problems (pre diagnosis) in patient s medical history. Can be used in medical note templates. Page 32 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings

33 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Sel = Select Set = Setup Ver = Verify Menu Access Description Action & Decision Lists > Diagnostic Codes Cornerstone provides a list of diagnoses that can be selected as either a tentative, ruled out or final diagnoses for a patient. Additions and corrections to this list can be made as needed. Diagnosis can be used for various reports, to set up compliance assessment and/or within the Patient Advisor * exam module. Used throughout Cornerstone in the following manner: View on a patient s Diagnosis tab on the Patient Clipboard Patient Diagnosis Report Diagnostic Code Report To set up Compliance Assessment tool compliance controls within Patient Advisor (if Patient Advisor has been purchased) to set diagnostic and treatment plans Ver Chapter Summary You learned these important concepts within this chapter: Security Settings Guide Overview Gain knowledge of Security Settings. Default Settings Guide Overview Successfully access defaults for the electronic medical record and electronic whiteboard. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Default Settings Page 33

34 Chapter 2: Reason for Visit Alerts & Documents Chapter 2: Reason for Visit Alerts & Documents You ll learn these important concepts within this chapter: Reason for Visit Verify/Create reasons for visit. Customizing the Scheduled Visit Display Set up reasons for visit/color codes. Page 34 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

35 Reason for Visit M In this lesson, you ll learn how to set up Reasons for Visits. Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup TRAINER-LED EXPLANATION Reasons for Visit are covered during the Defaults Phase of your training with a decision maker. At the time of completing the Appointment Scheduler setup, it is likely that the Reasons for Visit selections will already be set up. However, one Reason for Visit typically set up now is Appointment Not Available. This is used when setting up templates and the Practice doesn t want to schedule appointments for specific time periods. 1. From the Menu bar, select Controls > Reason for Visit. 2. Click New. 3. Enter the Reason for visit. 4. Optional: Enter an Alert note that will appear when a reason for visit is selected. 5. Optional: Link a document to print when patient is checked in or out. If the icon to the left of the Doc ID has the yellow arrow pointing to the right the document will print at check-in. If the icon has the green arrow pointing to the left the document will print at check-out. 6. Click OK. 7. Click Close. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 35

36 Chapter 2: Reason for Visit Alerts & Documents Customizing the Scheduled Visits Display M In this lesson, you ll learn how to customize the scheduled visit display. TRAINER-LED EXPLANATION Assigning Colors for Reasons for Visit Colors will display on the Appointment Scheduler and on templates based on the Reason for Visit selected when the appointment was set up. 1. From the Menu bar, select Controls > Appointment Scheduler > Reason for Visit. 2. Select the Reason for visit. 3. Click Update. 4. Select the Reason for Visit parameters on the Reason for Visit window. 5. To select a different color, click Set Color. Colors Using different colors for your Reasons for Visit will make the schedule easy to read at a glance. Performed by Indicates which staff member usually performs a particular type of appointment. Number of units Indicates how long this type of appointment usually takes. Appointment Scheduler will default the appointment for this amount of time. Dr/Asst Time Used to indicate when an appointment involves multiple staff members. 6. Select a color from the palette. Or, select Define Custom Colors and select a color. 7. Click OK to save the color. 8. Select OK to save the reason for visit information. Chapter Summary You learned these important concepts within this chapter: Reason for Visit Verify/Create reasons for visit. Customizing the Scheduled Visit Display Set up reasons for visit/color codes. Page 36 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

37 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Chapter 3: User Defined Prompts - Client and Patient You ll learn these important concepts within this chapter: Setting User Defined Prompts for Clients & Patients Create a user defined prompt. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 37

38 Chapter 3: User Defined Prompts - Client & Patient Setting User Defined Prompts for Clients & Patients In this lesson, you ll learn how to create and modify user defined prompts that will be helpful in a chartless practice. Menu Access Lists > Practice Description Verify that all the practice information is correct. The first phone number is the number that will print on plain paper estimates, invoices, statements and prescription labels. Sel = Select Set = Setup Ver = Verify Action & Decision Ver *If you are working with a FastInstall database you may have to Setup or Verify this default.

39 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Menu Access Controls > User Defined Prompts > Client Prompts Description Sel = Select Set = Setup Ver = Verify Prompts allow you to customize Cornerstone to store information that would be gathered for a new client. A client prompt can be set as an alert to bring certain information to the attention of your staff. You can further customize alerts by assigning them a color. If you want to store sensitive information these can be masked to hide details from people who should not be seeing it (see below). It is also possible to require that certain information be put into Cornerstone for every client. These fields can be set up as free type zones that let staff type characters or numbers to input data. They can also be set up as yes/no fields that allow staff to choose a yes or no answer. Finally, these fields can include custom designed lists that limit the information staff places within the field. Action & Decision Set Prompt Examples *Data Type C/N/Y N/L Alert Recommendations Status Active/Inactive Options R=Required M=Mask DOB No Employer No Preferred Dr. Yes Yes Special Alert Yes Entered By: No Yes *C=Character; N=Number; Y N=Yes/No; L=List Used throughout Cornerstone in the following manner: Client Prompts Report List data types appear in the Answer field (List > Clients > New or Update button > Client Information window > Prompts/Notes tab) as list selections. When a prompt is set up as an alert, the alert will show on the Patient Clipboard Appointment Scheduler, at check in, on an invoice, and on an estimate. Prompt Options set up as Mask hides all but the last four characters of user defined prompt data on reports and alerts. This is a useful feature when printing private client information such as driver licenses and credit card numbers. List

40 Chapter 3: User Defined Prompts - Client & Patient Chapter Summary You learned these important concepts within this chapter: Setting User Defined Prompts for Clients & Patients Create a user defined prompt. Page 40 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

41 Chapter 4: Medical Note Strategy Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup You ll learn these important concepts within this chapter: Medical Record Strategy Identify your practice s medical record strategy. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 41

42 Chapter 4: Medical Note Strategy Medical Record Strategy One task of a practice is to identify their medical note strategy. A practice may choose to adopt the following: Use medical notes for internal purposes only Use medical notes for internal and client interfacing purposes Use medical notes for internal medical notes and physical exam for client interfacing purposes You will need to make a decision about your practice s strategy up front, as this will drive the configurations and setup. Discussion Question: 1. For a wellness visit, what medical information is necessary or relevant for a medical team? For legal purposes? What medical notes are relevant to the client? What is the maximum form or level of medical notes that can be passed to a client in order for them to understand the care and increase value perception? 2. For a hospitalization, what medical information is necessary or relevant for a medical team? For legal purposes? What medical notes are relevant to the client? What is the maximum form or level of medical notes that can be passed to a client in order for them to understand the care and increase value perception? 3. Which features could be used to support your most frequent patient care routines? Example: Patient Care Routine: Wellness Patient Alert - Current Lifestage Smart Group - Wellness Exam Medical Note Template - Canine SOAP Physical Exam - Canine Wellness Client Correspondence - Current Lifestage Education for Breeding Departing Instructions - Our wellness philosophy includes exams, diet, and exercise... Reason for Visit - Annual wellness, senior wellness, etc. Fill this Patient Care Routine table in: Patient Care Routine: Patient Alert - Smart Group - Medical Note Template - Physical Exam - Client Correspondence - Departing Instructions - Reason for Visit - Page 42 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

43 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Chapter Summary You learned these important concepts within this chapter: Medical Record Strategy Identify your practice s medical record strategy. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 43

44 Chapter 5: Invoice Item Setup Chapter 5: Invoice Item Setup M You ll learn these important concepts within this chapter: Invoice Item Setup Basics Learn the basics about the types of invoice items: service, inventory, group, pick and dispense. Creating Pick Items - Successfully create lists to choose from during invoicing. Creating Dispensing Items - Successfully create and attach multiple dispensing fees to an inventory item. Link a Dispensing Item to an Invoice Item Link dispensing items to invoice items. Creating Smart Groups - Successfully setup group to take advantage of smart setting. Copying a Group to Another Group - Copy a group to another group. Setting Up Reminders Create and modify reminders. Setting Up Vaccine Information - Successfully Setup and invoice item to capture vaccine information. Special Actions - Gain knowledge of all automatic functions that can occur during invoicing. Page 44 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup

45 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Invoice Item Setup Basics M This provides an introduction to the types of invoice items. Invoice items are items you sell. They include products and services as well as common combinations of several items. Single invoice items are set up as service or inventory items. Item combinations are set up as groups, pick items or dispensing items. Invoice Item Information window There are five item types to choose from when you are setting up an invoice item. You can choose to set up an inventory Item, Service Item, Group Items, Pick Lists or a Dispensing Item. Inventory Items set up as Inventory items are generally in the classifications of: Nutritional Items Pharmaceuticals Supplies Skin Care Service Items set up as Service items are generally in the classifications of: Laboratory Testing Surgery Anesthesia Professional Services Grooming Boarding Vaccinations Dental procedures Hospitalization Radiology Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup Page 45

46 Chapter 5: Invoice Item Setup Group You can combine items that you often invoice at the same time into a group. When you add items to an invoice enter the Group ID and then all of the items in the group are added to the invoice. You can modify the items within the group on the invoice, if necessary. Smart codes extend the functionality of Groups. On invoices, smart codes provide flexibility to choose the proper treatment for a patient based on species, sex, age or weight. There are settings to mark the group item pricing up or down, ask before adding the items or ask for quantity. Once made smart, only items matching the patient or invoice criteria will be added to the invoice. Example: Dental Group Includes: Dental Examination (ask for update weight if none in the last 30 days) Pre-Surgical Labwork (ask before adding) Pre-Anesthetic Anesthesia (smart selection according to weight) Teeth Cleaning/Polish Dental Scaling Routine Fluoride Treatment Antibiotic Pick List (choose an item on the list) TPR Monitoring Extract Tooth Dental Radiographs Pick Cornerstone allows you to set up a pick list to be used in invoicing. Pick lists allow you to quickly choose one item from a list of related Invoice items. Example: Pain Medication Pick List The list may include these items: Fentanyl Patch Rimadyl 25mg Rimadyl 75mg Rimadyl 100mg Rimadyl Injectable Torbugesic 10mg/ml Torbugesic 50ml Torbugesic 1mg Torbugesic 10mg Dispensing Dispensing items are a type of invoice item. They may not be used by themselves, but instead are linked to an inventory invoice item record. This feature is useful if your practice dispenses an item in different ways. For example, if you have a drug that is used in the practice and is also dispensed as a prescription. When the drug is administered in the practice, you may want to charge an additional dispensing fee. When the drug is prescribed for a patient s use at home, you may not want to charge the additional dispensing fee. Examples: Inpatient Injection Administration Outpatient Injection Administration Medication Recommended by Doctor Page 46 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup

47 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Creating Pick Items M This lesson demonstrates creating a Pick item. Pick items are very helpful in choosing from a list of related invoice items. Use the Invoice Item Setup List located in the Appendix to help guide you through setting up invoice items. TRAINER-LED DEMONSTRATION 8 Create an Injection Pick List using the List option. 1. Select Lists > Invoice Item. [Lists > Invoice Item] 2. Click New. [New] 3. Select an item ID or allow Cornerstone to automatically assign one. 4. Select Pick as the item type. [Pick] 5. Enter a Hospital description. [Injection Pick List] 6. Optional: Enter a Client description. 7. Select a Classification. [PROFESSIONAL SERVICES - SMALL] 8. Optional: Enter a Subclassification. [Injections/Catheterization] 9. Select the Pick tab. 9.1 You can choose to create a pick item from Primary and/ or Subclass by selecting Classification. - or - If the items that you want to select for the pick item are in different classifications, then you can select the List option. [select List] 9.2 Enter item IDs for the user defined list and click Select. [Acepromazine Injectable, Amoxicillin Injectable, Baytril Injectable] 10. Select the Travel tab Click to highlight the travel sheets on which the pick item should appear. [select all travel sheets except Large Animal] 11. When complete, click OK to save. [OK] Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup Page 47

48 Chapter 5: Invoice Item Setup Creating Dispensing Items M This lesson demonstrates creating a dispensing item. Dispensing items are a type of invoice item and while they may not be used by themselves, they are linked to an inventory invoice item record. Dispensing items can be useful if your practice dispenses an item in different ways. Use the Invoice Item Setup List located in the Appendix to help guide you through setting up invoice items. TRAINER-LED DEMONSTRATION 8 Create a dispensing item for Oral Administration Fee. 1. From the Menu bar, select Lists > Invoice Item. [Lists > Invoice Item] 2. Click New. [New] 3. From the Information tab 3.1 Accept the item ID provided or enter one of your choosing. [accept ID provided] 3.2 Select the item type. [Dispensing] 3.3 Enter a Hospital description, which will appear in the Invoice Item List, in reports and in the patient s medical file. [Oral Administration Fee] 3.4 Optional: Enter a Client description. 3.5 Enter the revenue center to be used by default for this item. Dispensing items are a type of invoice item. They may not be used by themselves, but instead are linked to an inventory invoice item record. [Hospital] 3.6 Select the Status of this item. [Active] 3.7 Optional: Select the appropriate check boxes for Miscellaneous item, Controlled substance, Hazardous or MSDS. MSDS is only available if the Hazardous check box is selected. 3.8 Select Amount or Percent of inventory price. If Amount is selected, enter the amount for this dispensing item. If Percent of inventory price is selected, enter the percent of the inventory price. [Amount; $3.50] 3.9 If appropriate for this dispensing item, select the Override the inventory price and apply only the dispensing item fee check box. 4. Select the Instructions tab. 4.1 If it is appropriate to link departing instructions to this item, enter the departing instruction ID. Departing instructions print on invoices and are listed in the patient s medical history. 5. Select the Tax/Disc tab. 5.1 Select Sales taxes or Discounts appropriate for this dispensing item. 6. When the information regarding the setup of this Dispensing item is complete, click OK to save. [OK] 7. Click Close to exit. [Close] Page 48 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup

49 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Link a Dispensing Item to an Invoice Item M TRAINER-LED DEMONSTRATION Link the Oral Administration Fee dispensing item to Revolution Feline 5-15 (3) 1. Select Lists > Invoice Item. [Lists > Invoice Item] 2. Locate the invoice item. [Revolution Feline 5-15 (3), ID 7339] 3. Click Update. [Update] 4. Select the Information tab. 4.1 Click Dispensing. [Dispensing] 4.2 Select dispensing item.[oral Administration Fee] 5. Click OK. [OK] 6. Click OK. [OK] Creating Smart Groups M This lesson demonstrates how to create smart groups. Combine items that you often invoice at the same time into a group. Groups provide consistency and reduce missed charges helping your practice to become more efficient when with invoices, estimates or Patient Visit Lists. Smart Groups extend the functionality of Groups with the flexibility to choose the proper treatment for a patient based on species, sex, age and/or weight. To change the printing option for groups select Control > Defaults > Practice & Workstation. TRAINER-LED DEMONSTRATION 8 Set up a Grooming Group and make it smart. 1. From the Menu bar, select Lists > Invoice Item. [Lists > Invoice Item] 2. Click New. [New] 3. Accept the item ID provided or enter one of your choosing. [accept the ID provided] 4. Select the item type. [Group] 5. From the Information tab 5.1 Enter a Hospital description. [GROOMING GROUP] 5.1 Optional: Enter a Client description. 5.3 Select the Primary classification for the item. [GROOMING SMALL] 5.4. Optional: Select a subclass. 5.5 Enter the Revenue center to be used by default for this item. [Grooming] 5.6 Select the Status of this item. [Active] 5.7 Optional: If appropriate, select the Miscellaneous item check box. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup Page 49

50 Chapter 5: Invoice Item Setup 6. Select the Group Items tab. 6.1 Add invoice items to the group. [Grooming Sedation, Bath Group for Grooming, Comb Out Per 15 Min, Clip/Cut Pick List, Large Dog Surcharge, Grooming Nail Trim, Ear Cleaning] [When setting up your group, if an item is in bold print, it means that there is a group item within a group]. 7. Now that all of the items are entered, you will set up the smart items. On the line for Grooming Sedation, click the No button under the Smart? column to access the Smart Code Item window. [This window is where you will set the selection specifications for the group items]. 8. Highlighting a Species selection will prompt the item to be added only if the patient is a selected species. To select more than one species press and hold the Ctrl key. [Canine, Feline] [You must either select all species rows, or no more than four species]. 9. Highlighting a Sex selection will prompt the item to be added only if the patient is of the designated sex. [No change] [You must either select all Sex rows, or no more than two sexes]. 10. Specify a specific Age range. [No change] 11. More commonly, a Weight range is designated for certain items. If desired, you can also prompt for a weight to be entered, or for a weight to be entered only if one has not been recorded in the last 30 days. [No change] 12. Select the Ask user before adding this item check box option to ask the user before adding the item. [Select the check box] 13. Select the Stop and ask for quantity check box if the item requires a quantity greater than one. This feature is helpful for items such as pharmaceuticals or those that are based on time increments. [No change] 14. You can choose to change the group item pricing by either marking up or marking down the price by either a percentage of the price or an exact amount. You can also choose to ignore minimum prices. [None] 15. Click OK to save the smart settings. 16. Complete the smart settings for each of the following items: Invoice Item Bath Group for Grooming Comb Out Per 15 Min Clip/Cut Pick List Large Dog Surcharge Grooming Nail Trim Ear Cleaning Smart Settings The Bath Group for Grooming item is in bold text. This indicates that it is a group item within a group. It is already set up with smart settings. To view the settings, look up the Bath Group for Grooming in Lists > Invoice Item. Species: Canine, Feline Ask user before adding this item Stop and ask for quantity Species: Canine, Feline Species: Canine Ask user before adding this item Species: Canine, Feline Species: Canine, Feline Ask user before adding this item Page 50 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup

51 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup 17. As with estimates, Patient Visit Lists and invoices, you can change the order of the items by using the arrow buttons at the bottom of the window. 18. Select the Travel tab. 19. You may select multiple travel sheets on which this group item should appear. [None] 20. Click OK to save the setup, Copying a Group to Another Group M In this lesson, you ll learn to create a new group by copying information from an existing group. This option is only available when creating a group. TRAINER-LED DEMONSTRATION 8 In this lesson, you will copy items from an existing castration group to use as part of a new group for the Humane Society. 1. From the Menu bar, select Lists > Invoice Item. [Lists > Invoice Item] 2. In the Invoice Item List window, select New. 3. From the Information tab 3.1 Accept the item ID provided or enter one of your choosing. [accept ID provided] 3.2 Select an item type. [Group] 3.3 Enter the Hospital description.[neuter HUMANE SOCIETY] 3.4 Select the Primary Classification. [Surgery Small] 3.5 Optional: Select a Subclassification. 4. Select the Group Items tab. 4.1 Double click in the Copy line items from group ID field to access the Invoice Item List Locate and select the group that you will copy. [ALTER GROUP] 4.3. Add or edit items in the group. 4.4 Optional: To change the price of the group, each item s price needs to be changed. a. Click the Yes smart button for the first item. b. In the Group item pricing area, select the Mark Up or Mark Down options to alter the price. [mark the first item down by 50%] c. Optional: Select the Ignore Minimum Price check box to allow the price to go below the specified minimum price. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup Page 51

52 Chapter 5: Invoice Item Setup 5. Click OK to save the pricing change. [OK] 6. Optional: Change the pricing for other items in this group. 7. Select the Travel tab. 7.1 Select travel sheets on which this item will be included. [Surgery] 8. Click OK to save the new group item. [OK] 9. Close the Invoice Item List window. [Close] Invoice Items to Generate and Satisfy Reminders M In this lesson, you ll learn to set up the reminders that an invoice item generates and the reminders it satisfies. TRAINER-LED DEMONSTRATION 8 In this demonstration, you will set up the reminders for the PNEUMABORT K 7 MO PG item. You can review the reminder information from the Invoice Item Reminder Information Report. Trainee Note: In the Invoice Item List verify that each item that will be included in this series is set up. From the Invoice Item List if an item is not yet set up, you will need to set it up before continuing. Reminders Tab R=Required Field; O=Optional Field; NA=Not Applicable Inventory Field Description/Explanation Inventory Service Group Pick Dispensing Exclusive Field Reminders to Generate and Reminders to Satisfy When setting up an invoice item to generate a reminder postcard or a call back and to satisfy letter reminders use the Reminders tab. O O NA NA NA 1. From the Menu bar, select Lists > Invoice Item. [Lists > Invoice Item] 2. In the Invoice Item List, type characters for item(s) being searched. [pneuma] 3. Select the invoice item you are going to work with and click Update. [PNEUMABORT k 7 MO PG]. 4. Select the Reminders tab. There are two areas in this window: the Reminders to generate area and the Letter reminders to satisfy area. Reminders to Generate 4.1 Right-click in the Reminders to generate area and select New. 4.2 Double-click or F2 in the Item ID box to locate and select the item from the Invoice Item List that this item is going to generate a reminder. [PNEUMABORT K 9 MO PG] 4.3 Select whether the reminder type is to be a Letter (postcard, letter, tri-fold and ) or a Call. [Letter] 4.4 Select the Ask for months/days in invoicing check box if you want the due date to be set when the item is invoiced. 4.5 To schedule a due date, enter the number of Days or Months that will pass before the reminder will be generated. [2 months] 4.6 Click OK to save the reminder information. [OK] Page 52 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup

53 Letter Reminders to Satisfy Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup 4.7 To set up a reminder that the item will satisfy, right click in the Letter reminders to satisfy area and select New. [New] 4.8 This item should satisfy the reminder for the PNEUMABORT K 5 MO PG item. PNEUMABORT K 5 MO PG Because all items satisfy the reminders for themselves. You do not create an entry for the PNEUMABORT K 7 MO PG item. 4.9 Click OK to save the reminder information. 5. The reminder information for this item is complete, click OK in the Invoice Item Information window to save the information. [OK] 6. Click Close to exit the Invoice Item List. [Close] Setting up Vaccine Information This lesson will provide information needed to fill out the vaccine tab on the invoice item information window. Inventory Tab R=Required Field; O=Optional Field; NA=Not Applicable Field Description/Explanation Inventory Service Group Pick Dispensing Inventory Exclusive Field NDC/DIN Code NDC is the United States National Drug Code. DIN is Canada s Drug Identification Number and shows that the manufacturer is able to distribute O NA NA NA NA the drug. In both cases, it is a national number that describes the drug. Serial number This can be the vendor s product number. O NA NA NA NA Maintain QOH Select this option to track this item in inventory. O NA NA NA NA X Track expiration dates Track lot numbers Buy/sell ratio Select this option to track expiration dates for this item. This is only an option if the item is set to Maintain QOH. Staff will be required to enter an expiration date when depleting a quantity of this item from inventory. Select this option to track lot numbers for this item. This is only an option if the item is set to Maintain QOH. Staff will be required to enter a lot number when depleting a quantity of this item from inventory. If maintaining the item s quantity on hand, select and enter the buy/sell information. O NA NA NA NA X O NA NA NA NA X Examples: 1 bottle = 200 tablets. Explanation: Set the buy UOM to equal the UOM that you purchase/receive. If you receive 1 bottle of 200 tablets, then the buy/sell ratio should be 1 Bottle = 200 Tablets and you ll be able to sell 1 tablet. O NA NA NA NA Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup Page 53

54 Chapter 5: Invoice Item Setup Inventory Tab R=Required Field; O=Optional Field; NA=Not Applicable Field Description/Explanation Inventory Service Group Pick Dispensing Buy Barcode If you have a bar code scanner, buy Barcode is used for the selling unit of measure. It is typically found on the label of the box/bottle/container. A Buy barcode AND A Sell barcode can both be O NA NA NA NA listed ONLY if the buy to sell ration use different units of measure (i.e. 1 box to 12 bottles; 1 case to 24 cans). Item Vendor Select this option for vendor information. O NA NA NA NA Stock at locations list Reorder Information by Location Select Location From and To Reorder Pt. Highlight the locations where this inventory item is stored. Locations are setup in inventory. Set Dates, Reorder Points, Reorder Quantities, and Overstock Points for each location the item is stored. When the inventory module feature is configured to multi-location inventory, this field becomes available. If the item is seasonal, change the months the information is valid and enter the Reorder Pt, Reorder Qty, and Overstock Qty for each period. If the item is not seasonal, type the information for the Jan. to Dec. period that displays. The number of doses at which the reorder should be placed. O NA NA NA NA O NA NA NA NA O NA NA NA NA O NA NA NA NA Reorder Qty. How many units should be reordered. O NA NA NA NA Overstock Qty. The number of units in inventory after which additional units would be considered overstock. O NA NA NA NA Inventory Exclusive Field Vaccine Tab R=Required Field; O=Optional Field; NA=Not Applicable Field Description/Explanation Inventory Service Group Pick Dispensing Inventory Exclusive Field Issue Vaccination Tag Rabies Tag Producer/Mfg: Throughout Cornerstone, rabies tag settings have been renamed vaccine tag to encompass all types of vaccinations, including rabies and large animal vaccines (e.g., Brucellosis vaccinations). You can now set up the most frequently used Manner of Administration/Years combinations for each species. These combinations can be added, deleted and managed from the Vaccine tab. The Producer/Mfr can be tied directly to the product being administered. O NA NA NA NA X O NA NA NA NA X O NA NA NA NA X Page 54 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup

55 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Inventory Tab R=Required Field; O=Optional Field; NA=Not Applicable Field Description/Explanation Inventory Service Group Pick Dispensing Brand Type The Brand is also tied to the product being administered. The type allows you four choices: Killed, Modified Live virus (MLV), Recombinant, or Other Inventory Exclusive Field O NA NA NA NA X O NA NA NA NA X Administration by Species Manage List Available Lot Numbers and Expiration Dates You can now set up the most frequently used Manner of Administration/Years combinations for each species. The combinations of administration/years can be added, deleted and managed through the Manage List option. You can create a list of available lot numbers/expiration dates that will be available to select when creating the vaccine tag. O NA NA NA NA X O NA NA NA NA X O NA NA NA NA X Special Actions This lesson provides an overview of the special action options. Special Actions can provide easy ways to prompt staff to remember to perform certain tasks such as: printing a rabies certificate when you invoice for a rabies vaccine, updating a weight/vital signs in the patient history, printing an anesthesia consent form when a patient checks in for a surgery or procedure. Special Actions can also be set up to prompt Cornerstone into performing action automatically or allowing you to perform the task manually, in some cases you can choose when to perform the task (invoice, PVL, etc). Special Action When to Apply Application Feeding Guide Software Optional on invoice n/a Lab Request Immediately on invoices/pvl Attach a Profile Mark as Deceased Optional on invoice n/a Prescription Label Immediately on invoices/pvl Optional on invoice n/a Print Document Print after invoice posted Optional on Invoice Immediately on invoice/pvl Before invoice is posted Attach a Document Sex Modification Optional on invoice Update Microchip ID Optional on invoice Immediately on invoice/pvl Before invoice is posted n/a Optional on invoice Select the number of days to check in patient s history for an updated Update Vital Signs Immediately on invoice/pvl Before invoice is posted weight. If no weight recorded within that time frame Cornerstone will prompt you to add a weight. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup Page 55

56 Chapter 5: Invoice Item Setup Special Action When to Apply Application Vaccine Tag Optional on invoice Before invoice is posted Immediately on invoice/pvl n/a Chapter Summary You learned these important concepts within this chapter: Invoice Item Setup Basics Learn the basics about the types of invoice items: service, inventory, group, pick and dispense. Creating Pick Items - Successfully create lists to choose from during invoicing. Creating Dispensing Items - Successfully create and attach multiple dispensing fees to an inventory item. Link a Dispensing Item to an Invoice Item Link dispensing items to invoice items. Creating Smart Groups - Successfully setup group to take advantage of smart setting. Copying a Group to Another Group - Copy a group to another group. Setting Up Reminders Create and modify reminders. Setting Up Vaccine Information - Successfully Setup and invoice item to capture vaccine information. Special Actions - Gain knowledge of all automatic functions that can occur during invoicing. Page 56 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup

57 Chapter 6: Vital Signs Setup M You ll learn these important concepts within this chapter: Vital Signs Setup Features and Benefits of using Vital Signs. Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Vital Sign Types Understand the difference between the vital sign types: numeric, numeric list, alphanumeric and alphanumeric list. Quick Start Steps Understand the quick start steps needed for vital signs setup. Setting Up & Activating the Vital Sign List for your Practice Add and edit vital signs and setup vital sign display orders. Editing the Weight Vital Sign Edit the weight vital sign. Vital Sign Bookmarks Add a vital sign bookmark. Check-in Report Print Options Check-In Report print options for Weight/Body Score and Vital Signs. Deleting a Vital Sign Delete a vital sign. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 57

58 Chapter 6: Vital Sign Setup Vital Signs Overview M Vital Signs functionality in Cornerstone allows you to record vital signs and access them throughout Cornerstone in all areas where patient weight has traditionally been displayed. The Vital Signs window provides one central location to review historical vital signs for a patient, and allows you to more easily identify changes in a patient s health through comparative trending and graphing. TRAINER-LED EXPLANATION Using the Vital Signs window you can: View, add, edit and graph vital signs for a patient Include vital signs information in medical notes Include vital sign information on Pet Health Report Cards created using Physical Exam/Patient Advisor* Exam. Page 58 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

59 Vital Signs Type M If you want to create your own vital signs to use in your practice s Vital Sign List, think about the way you want staff members to enter/select values for each vital sign this will determine the type of vital sign to select during setup. TRAINER-LED EXPLANATION Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Alphanumeric With an Alphanumeric vital sign, at the time of use the value is free-form typed as letters and/or numbers. Blood Pressure is an example of an alphanumeric vital sign. Example of the alphanumeric type during setup Example of an alphanumeric type entry Alphanumeric List With an Alphanumeric List vital sign, at the time of use a value is selected from a list of pre-configured answers containing letters and/or numbers. Mucous Membranes is an example of an Alphanumeric List vital sign. Example of the Alphanumeric List type during setup Example of the Alphanumeric List type during use Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 59

60 Chapter 6: Vital Sign Setup Numeric List With a Numeric List vital sign, at the time of use a value is selected from a pre-configured list, where the values are based on a numeric scale with a start value of 0 or 1. You can also simply type the number to quickly assign the associated value in the list. Numeric List vital signs can be graphed. Example of the Numeric List type during setup Example of the Numeric List type during use Numeric With a Numeric vital sign, you have the option of setting up one or more numeric ranges to serve as a warning mechanism that alerts you when a value is entered outside the normal range for the species. For example, a Temperature vital sign could be set up to use a range of 95 (low) to 101 (high). Numeric vital signs can be graphed. Example of a Numeric type entry Example of a Numeric type entry Page 60 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

61 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Quick Start Steps M TRAINER-LED EXPLANATION Quick-Start Steps for Vital Signs Setup To get up and running quickly using the default vital signs, follow these two easy setup steps: Activate the vital signs you want to track Assign species to applicable lists for Alphanumeric List and Numeric vital signs 1. Go to Lists > Vital Signs/Weight. 2. Select a vital sign and click Update. 3. Clear the Inactive check box to activate it. 1. Go to Lists > Vital Signs/Weight. 2. Select an Alphanumeric List or Numeric List vital sign and click Update. 3. Select a list and then select the applicable species to associate it with the list. To take advantage of additional vital signs customization features, consider these optional steps: O P T I O N A L Add normal low/high ranges and assign species to each range for Numeric vital signs (Cornerstone will alert staff for values entered outside the range) Set the vital signs display order Set Check-in Report print options for vital signs Add vital signs functionality to a Physical Exam/Patient Advisor Exam body system 1. Go to Lists > Vital Signs/Weight. 2. Select a Numeric vital sign and click Update. 3. Add a range and specify its Low and High values. 4. Select the applicable species to associate with the range. 1. Go to Lists > Vital Signs/Weight. 2. Click Set Order. 3. Use the arrow buttons to move each vital sign to the desired position in the list. 1. Go to Controls > Defaults > Practice and Workstation. 2. In the Check-in > Check-in Print Options defaults, select the Weight/Body Score and Vital Signs check boxes if you want this information to print on the Check-in Report. 1. Go to Lists > Physical Exam > Physical Exam Setup (or Lists > Patient Advisor > Patient Advisor Setup). 2. Select a system and click Update. 3. Select the Vital Sign System check box and click OK. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 61

62 Chapter 6: Vital Sign Setup Setting Up and Activating the Vital Sign List for Your Practice M TRAINER-LED EXPLANATION The setup fields available on the Vital Sign Setup window differ depending on the data type (alphanumeric, numeric, etc.) selected for the vital sign you are configuring. To add or edit a vital sign (all vital sign types): 1. On the Lists menu, select Vital Signs/Weight. The Vital Sign List window displays. 2. Click New to add a new vital sign or double-click an existing vital sign to edit its settings. The Vital Sign Setup window displays. 3. In the Name field, type a descriptive name to uniquely identify this vital sign. 4. If you want to activate this vital sign, clear the Inactive check box. (Conversely, to mark it as inactive, select the Inactive check box.) 5. In the Abbreviation field, type a shortened version (maximum 10 characters) of the vital sign name. This abbreviation will display in the Vital Signs column (static left column) on the Vital Signs entry and viewing window and in the column headers on the Patient Clipboard* Vital Signs tab. 6. If setting up a new vital sign, in the Type field, select Alphanumeric, Alphanumeric List, Numeric List or Numeric. 7. Depending on the vital sign type selected, do one of the following: For Alphanumeric, the setup is complete. Click Save to save and return to the Vital Sign List. For Numeric, proceed to the section for setting up a Numeric vital sign. For Numeric List or Alphanumeric List, proceed to the section for setting up a Numeric List or Alphanumeric List vital sign. Setting the Vital Signs Display Order During setup, you can specify the order of the vital sign rows that display in the Vital Signs column on the Vital Signs window at the time of use. To add or edit a vital sign (all vital sign types): 1. On the Lists menu, select Vital Signs/Weight, then click Set Order. The Vital Sign Order window displays. 2. Multi-Location/Single Database configurations only: If desired, you can customize the vital signs display order for each practice. In the Practice drop-down list, select the practice for which you want to set up the vital signs display order. 3. Highlight a vital sign and then use the up or down arrow button to move the vital sign to the desired position in the list. Repeat this process until the vital signs are in the desired order. Page 62 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

63 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup 4. Multi-Location/Single Database configurations only: If you are setting the order differently for each practice, repeat steps 2 3 for each practice. 5. When you are finished, click OK. Editing the Weight Vital Sign M As with Numeric vital signs that allow you to set up high and low value ranges, the Weight vital sign can be edited to add high and low weight ranges appropriate for the species regularly seen in your practice. In addition, you can specify different units of measure for each range based on species size. For example, you could set up a range for the Avian species that has the Unit of measure set to grams. TRAINER-LED EXPLANATION To edit the Weight vital sign: 1. On the Lists menu, select Vital Signs/Weight, then double click the Weight vital sign to edit its settings. 2. If desired, change the number of Decimal Places to be used for recording the weight (applies across all ranges/species/units of measure). 3. If desired, you can set up weight ranges to alert staff for values entered outside the range. 4. For each range, select a Unit of measure appropriate for the range and the associated species. 5. When you are finished, click Save to save and return to the Vital Sign List. Vital Sign Bookmarks M If desired, an Add vital signs prompt link can be added to a document template (medical note or correspondence document) during setup. With the prompt in place, at the time of use the staff member can simply click on the prompt link and select the patient s vital signs information to insert in the document. TRAINER-LED EXPLANATION To insert an Add vital signs prompt in a document template: 1. On the Lists menu, select Documents > Templates and create a new template or update an existing template. 2. With the document template open in the Cornerstone Editor, place your cursor in the desired location. 3. Right-click and select Insert > Vital Signs Prompt. The prompt displays in the document template as an underlined link. 4. Save your changes. Check-In Report Print Options M TRAINER-LED EXPLANATION To set Check-In Report print options for Weight/Body Score and Vital Signs: 1. On the Controls menu, select Defaults > Practice and Workstation. 2. In the navigation pane on the left, click Check-in and then click Check-in Print Options. 3. If you want the Weight/Body score and Vital Signs information to print on the Check-in Report, select the appropriate check boxes and then specify the range of information to print (All, Last month, Last 3 months, etc.). 4. When you are finished, click OK. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 63

64 Chapter 6: Vital Sign Setup Deleting a Vital Sign M You can delete a vital sign from the Vital Sign List only if the vital sign has never been used to record vital signs for a patient. If the vital sign has been used (even for a test patient), it cannot be deleted. TRAINER-LED EXPLANATION To delete a vital sign from the Vital Sign List: 1. On the Lists menu, select Vital Signs/Weight. 2. On the Vital Sign List window, select the desired vital sign and click Delete. You are prompted to confirm the deletion. Click Yes. Other Procedural Steps To copy a vital sign 1. On the Lists menu, select Vital Signs/Weight. 2. On the Vital Sign List window, select the desired vital sign and click Copy. 3. On the Vital Sign Setup window, enter a new name and abbreviation for the vital sign, and make other changes as necessary. 4. When you are finished, click Save to save and return to the Vital Sign List. To set the Ask for weight default for medical notes 1. On the Controls menu, select Defaults > Practice and Workstation. 2. In the navigation pane on the left, click Documents. 3. In the Medical note options area, type a number in the Ask for weight if the last entry is older than days field to specify the number of days to use for determining if the most recent patient weight entry is considered current. 4. When you are finished, click OK. Adding Vital Signs Functionality to Physical Exam/Patient Advisor Exam Body Systems If desired, you can set up certain Physical Exam/Patient Advisor Exam body systems as vital sign systems that will include a Vital Signs/Weight icon next to the system on the Observations tab at the time of use. To set up a Physical Exam/Patient Advisor Exam body system as a vital sign system 1. On the Lists menu, select Physical Exam > Physical Exam Setup (or Lists > Patient Advisor > Patient Advisor Setup). 2. Select a system and click Update. 3. If you want the Vital Signs/Weight icon to appear with this system in the Physical Exam/Patient Advisor Exam Observations tab, select the Vital Sign System check box and click OK. Special Action for Updating Vital Signs You can set up a vital signs entry task that s associated with an invoice item by linking the Update Vital Signs special action to the item. When you process this special action, the Vital Signs window displays, allowing you to view, add or update vital signs for the patient. Page 64 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

65 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Adding an Add vital signs Prompt to a Document Template During Template Setup 1. On the Lists menu, select Documents > Templates and create a new template or update an existing template. 2. With the document template open in the Cornerstone Editor, place your cursor in the desired location. 3. Right-click and select Insert > Vital Signs Prompt. The prompt displays in the document template as an underlined link. 4. Save your changes. Setting Up a Vital Signs Entry Invoice Item to be Used in Whiteboard Patient Orders To set up a vital signs entry item to prompt staff when completing Whiteboard patient treatments (basic steps): 1. Create an invoice item (typically a service item) that links to the Update Vital Signs special action. 2. During setup, in the When to apply field, select Immediately on invoice/pvl (this option also applies to the Whiteboard Patient Treatments window).. 3. In the Weight days field, enter the time range in days that the weight is considered current for this item. If a weight has been entered for the patient within this timeframe, the patient s vital signs are considered to be up to date and the special action will not be triggered on the invoice/pvl/whiteboard Patient Treatments. 4. When entering orders on the Whiteboard Patient Orders window, add the vital signs entry item to the orders and set options such as billing/not billing, frequency, etc. for the item.[staff will be prompted to record vitals for the patient every time the order item is completed on the Patient Treatments window (with Completed selected, when you click OK, the Vital Signs window displays).] Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 65

66 Chapter 6: Vital Sign Setup Chapter Summary You learned these important concepts within this chapter: Vital Signs Setup Features and Benefits of using Vital Signs. Vital Sign Types Understand the difference between the vital sign types: numeric, numeric list, alphanumeric and alphanumeric list. Quick Start Steps Understand the quick start steps needed for vital signs setup. Setting Up & Activating the Vital Sign List for your Practice Add and edit vital signs and setup vital sign display orders. Editing the Weight Vital Sign Edit the weight vital sign. Vital Sign Bookmarks Add a vital sign bookmark. Check-in Report Print Options Check-In Report print options for Weight/Body Score and Vital Signs. Deleting a Vital Sign Delete a vital sign. Page 66 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

67 Chapter 7: Electronic Whiteboard Setup M M You ll learn these important concepts within this chapter: Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Customization Recommendations View and adjust various defaults and setups that improve the effectiveness of Whiteboard in your practice. Customize categories, areas, frequencies, patient hospital statuses, and wards/locations that make it easy for your staff to use the Electronic Whiteboard. Memorized Patient Orders Using the tables in this chapter, plan how you ll use the combination of your billable Smart Groups and the Hospitalized Whiteboard and Outpatient Whiteboard groups. After planning, go to the Patient Orders window and memorize the most common. Defaults and Security Become acquainted with Whiteboard defaults and security options. Other Customization Recommendations Adjust setups to accommodate invoice items with dispensing fees for scenarios where prescriptions are dispensed from the patient vial/bottle and/or a Pharmacy bottle. Other Procedure Steps Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 67

68 Chapter 7: Electronic Whiteboard Setup Customization Recommendations M Your staff s effectiveness when using the Electronic Whiteboard is impacted by proper setup. In this lesson, ensure you have done the following in your real database: TRAINER-LED DEMONSTRATION M 1. r Make Category changes so the Patient Treatments window categories have a general order that works for your medical team 2. r Make Frequency changes so that: A. Practice hours and treatment times are reflected in the provided frequencies already set up in your database B. You can treat every hour, every other hour, start today with the same time tomorrow and start today with a different time tomorrow. C. Patient Visit List charges will be calculated properly (Billing Type X Frequency = Patient Visit List charge) Patient Orders Page 68 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

69 Category 1. Lists > Electronic Whiteboard > Categories Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Frequency 2. Lists > Electronic Whiteboard > Frequencies Using a sample drug invoice item, make sample entries for these scenarios: Treat every hour Treat every other hour Start today at certain time with the same time tomorrow Start today at certain time with a different time tomorrow Start tomorrow at a certain time Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 69

70 Chapter 7: Electronic Whiteboard Setup 3. r Select Lists > Wards/Loc. Customize Ward/Locations so that you may filter # of patients in certain area of practice on the main Whiteboard window above. 4. r Select Lists > Electronic Whiteboard > Areas. Customize Areas so that you may, for example, view lab work the technicians have for the day using the main Whiteboard window above. 5. r Select Lists > Patient Hospital Statuses. Customize Patient Hospital Statuses so that at a glance, any staff member can see the current status. Additional statuses created will be treated as Ready to Go Home & will bypass whiteboard default settings. Page 70 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

71 Memorized Patient Orders M Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Most practices use a combination of billable and non-billable invoice items on the Whiteboard. Plan your Whiteboard use using the two basic tables below. Also consider planning for: Boarding, Sick/Hospitalized, and Emergency TRAINER-LED DEMONSTRATION M After completing your planning work below, use an employee patient or your practice mascots and memorize the most common patient orders. 1. From the Cornerstone toolbar, click the Patient Clipboard toolbar button. 2. Enter or search for the Client ID. [Select an employee account or house account.] 3. Select and right-click your patient. [Select an employee s pet or a practice mascot. ] 4. Select Electronic Whiteboard > Patient Orders. 5. Complete the Patient Orders using the tables below. 6. Discontinue the treatments and remove the patients from the Whiteboard when finished. Hospitalized Whiteboard Group Administer Medication Blood Draw Call Client Check Appetite Check Bandage Check Stool Check for Vomiting Check Incision Feed Feed (Owner Food) Monitor Appetite & Drinking Monitor Urination Vital Signs Walk Water Clean Cage/Change Litter Procedure (A write in for the main procedure) Other Smart Group: Surgery Enter one of your most frequently used surgery Smart Groups. Place a checkmark for those invoice items that will be entered on the Whiteboard. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 71

72 Chapter 7: Electronic Whiteboard Setup Outpatient Whiteboard Group Administer Medication Blood Draw Call Client Water Clean Cage / Change Litter Remove Catheter Vital Signs Observations Procedure Other Smart Group: Wellness/ Drop-Off Place a check mark for those invoice items that will be entered on the Whiteboard. Defaults and Security M TRAINER-LED DEMONSTRATION M Review your Whiteboard defaults and security to ensure data integrity and efficiencies for your practice. 1. r Visit Controls > Defaults > Practice & Workstation > Whiteboard. Page 72 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

73 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Action & Decision Whiteboard auto refresh timer Minutes Type in a number (or use the up/down arrows) to set the Whiteboard auto refresh timer rate defaults (in minutes) for refreshing the Electronic Whiteboard. Set Whiteboard See Fig. HH Length of time to keep discharged patients on Whiteboard Hours Type in a number (or use the up/down arrows) to set up Length of time to keep discharged patients on Whiteboard defaults (in hours). Set Doctor to use the invoice line Select a default Doctor to use on invoice line from the list. Options are Supervising doctor, Current Care doctor or actual staff who performed the item. The primary and care doctors are determined at the time orders are written. Performing staff is determined at the time items are marked completed. Set Use doctor from Patient Visit List Check this box if you want the staff from the Patient Visit List invoice item lines to transfer as the doctor for the patient orders. Set Invoice when patient is at Ready to go home status Determines under which circumstances a staff member is allowed to invoice a client for a patient who is still in the not ready to go status on the Electronic Whiteboard. Sel Allow invoice if uncompleted treatments Determines under which circumstances a staff member is able to invoice a client when a patient has treatment on the Electronic Whiteboard that has not been marked complete. Sel Future hours to check for uncompleted treatments when invoicing Hours Set the default number of hours for Future hours to check for uncompleted treatments when invoicing. Sel Fig. HH (Controls > Defaults > Practice and Workstation > Whiteboard property) Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 73

74 Chapter 7: Electronic Whiteboard Setup 2. r Visit File > Security Setup and view Whiteboard security options. Foundation Dialog Security Access Suggestions GEN REC DR TECH M/O Path to Locate Ward/Loc Information X Lists > Ward/Loc Ward/Loc List X X X X X Lists > Ward/Loc Whiteboard X X X X Activities > Electronic Whiteboard > Whiteboard Whiteboard Area Information X Lists > Electronic Whiteboard > Areas Whiteboard Area List X X X X X Lists > Electronic Whiteboard > Areas Whiteboard Category Information X Lists > Electronic Whiteboard > Categories Whiteboard Category List X X X X X Lists > Electronic Whiteboard > Categories Whiteboard Complete Task X X X X Lists > Electronic Whiteboard > Categories Whiteboard Frequency Information X Lists > Electronic Whiteboard > Frequencies Whiteboard Frequency List X X X X X Lists > Electronic Whiteboard > Frequencies Whiteboard Invoice Posting Override X X Activities > Invoice (Message displays) Lists > Electronic Whiteboard (To change status) Whiteboard Patient Orders X X Activities > Electronic Whiteboard > Patient Orders Whiteboard Patient Treatments X X X X Activities > Electronic Whiteboard Whiteboard Patient Visit List (PVL) X X X X Patient Clipboard > Select Client > Rightclick Patient > Electronic Whiteboard > Patient Orders > PVL Whiteboard Remove Patient X X X Whiteboard > right-click patient > select Remove from Whiteboard Whiteboard Undo Treatment X X X X Patient Clipboard > Select Client > Rightclick Patient > Electronic Whiteboard > Right-click Treatment > Select Patient Orders > Right-click Patient Order > Discontinue treatment This table contains suggested security settings for General Login (GEN), Receptionists (REC), Technicians (TECH), Doctors (DR), and Managers/ Owners (M/O). However, it is ultimately the practice s decision-maker that decides who has access to certain areas within Cornerstone*, and IDEXX shall not be liable for any actions arising from those security decisions. Page 74 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

75 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Other Customization Recommendations M Your practice may need to be prepared to use the Whiteboard to enter orders for items with dispensing fees. With dispensing items, you may need to dose from a patient vial/bottle or dose from the Pharmacy. Here are your options: Dose from Patient Vial Create original prescription Enter patient order for administering medication (fee or non billable) Dose from Pharmacy Create dispensing items & attach to inventory items Remove dispensing fee TRAINER-LED DEMONSTRATION Review an inventory report to view dispensing fees and items. Discuss and/or make setup changes to accommodate dispensing from patient vials/bottles and/or dosing from the Pharmacy. Use the instructions below to add dispensing fee, if applicable. 1. From the Menu bar, select Lists > Invoice Item. 2. In the Invoice Item List window, click New. 3. Accept the item ID provided or enter one of your choosing. 4. Select the Dispensing option as the item type. The Invoice Item Information window displays three tabs. 5. Enter the name of your dispensing item in the Hospital description field. [Oral Administration Fee] 6. Enter the Default revenue center for this dispensing item, if applicable. [H] 7. In the Dispensing fee area, select Amount and enter the dispensing fee amount that you want added to the cost of the item, or select Percent of inventory price and enter the percentage. [Enter applicable amounts for your practice] You have the option to select the Override the inventory price and apply only the dispensing fee check box if you want to use only the amount specified here instead of any amount or dispensing fee found on the item s record. 8. Click OK to save your changes. Other Procedural Steps Modified Pricing Solutions Estimate or Patient Visit List items with modified prices revert to normal price upon completion from Whiteboard for these scenarios: 1. Smart Group using price mark up/down 2. Items with Estimate Markup % 3. Manually modified prices Use these techniques as solutions for price changes after Whiteboard completion: Smart Groups (Cornerstone 8.0 & lower) Move and process entire group from Patient Visit List to whiteboard Leave special price items on Patient Visit List & add no bill items to Patient Orders Adjust groups to not use mark up/ mark down feature Always check Patient Visit List before invoicing Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 75

76 Chapter 7: Electronic Whiteboard Setup Items with Estimate Markup %(Cornerstone 8.0 & lower) Leave special price items on Patient Visit List & add no bill items to Patient Orders. Remove estimate markups Always check Patient Visit List before invoicing Manually modified prices (Cornerstone 8.0 & lower) Leave special price items on Patient Visit List & add no bill items to Patient Orders Always check Patient Visit List before invoicing Chapter Summary You learned these important concepts within this chapter: Customization Recommendations View and adjust various defaults and setups that improve the effectiveness of Whiteboard in your practice. Customize categories, areas, frequencies, patient hospital statuses, and wards/locations that make it easy for your staff to use the Electronic Whiteboard. Memorized Patient Orders Using the tables in this chapter, plan how you ll use the combination of your billable Smart Groups and the Hospitalized Whiteboard and Outpatient Whiteboard groups. After planning, go to the Patient Orders window and memorize the most common. Defaults and Security Become acquainted with Whiteboard defaults and security options. Other Customization Recommendations Adjust setups to accommodate invoice items with dispensing fees for scenarios where prescriptions are dispensed from the patient vial/bottle and/or a Pharmacy bottle. Other Procedure Steps Page 76 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

77 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Chapter 8: Physical Exam Setup You ll learn these important concepts within this chapter: Physical Exam Defaults: Setup your practice physical exam defaults. System Templates: Create and modify system templates. Systems: Create and modify systems. Observations: Create and modify observations. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup Page 77

78 Chapter 8: Physical Exam Setup Physical Exam Defaults M This lesson will help your practice to set Cornerstone defaults for physical exam. Menu Access Lists > Physical Exam > System Templates > New > Description Description In the Description field, enter a descriptive name for the system template. Sel = Select Set = Setup Ver = Verify Action & Decision Set Lists > Physical Exam > System Templates > New > Default Select the Default check box to use this template for the majority of your physical exams. Set Page 78 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup

79 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Menu Access Lists > Physical Exam > System Template > New > System List Description The following setup selections are optional: Select gray box to left of a system to include a body system on the template. Sel = Select Set = Setup Ver = Verify Action & Decision Sel Select default observation status: Normal, Abnormal or Did Not Examine. Arrange systems in the order they will appear on the physical exam and the Pet Health Report Card. Sel Sel Lists > Physical Exam > Physical Exam Setup > New System Select the system template and body system then click New. Sel Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup Page 79

80 Chapter 8: Physical Exam Setup Menu Access Lists > Physical Exam > Physical Exam Setup > New Observation Description Click on the = to the left of the body system > click on the + to the left of Observations > select a Status > click New. Sel = Select Set = Setup Ver = Verify Action & Decision Sel Lists > Physical Exam > Physical Exam Setup > Observation Setup Select System from list, if needed. Select an Observation type from the list, if needed. If observation is species specific, select a Species from the list. Select the Default check box to set as default. Enter text for Observation text as shown below. Sel Sel Sel Sel Set Page 80 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup

81 System Templates M This lesson demonstrates creating physical exam system templates. TRAINER-LED DEMONSTRATION Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup 1. From the Lists menu select Physical Exam and then System Templates. [Lists > Physical Exam > System Templates]. 2. Select New. 3. In the Description field, enter a descriptive name for the system template. [Adult] [The system template description will save to the patient file]. 4. Select the Default check box to use this template for the majority of your physical exams. [Select check box]. [You can only have one default template and if another template is marked as the default, selecting this Default check box will deselect the other template.] 5. Select the gray box to the left of a system to include the body system on the template. [Appearance, Weight, Temperature; Breed Predispositions; Age-Specific Concerns; Behavior; Eyes; Ears; Mouth and Teeth; Respiratory; Cardiovascular; Abdomen and Abdominal Organs; Gastrointestinal; Skin and Hair Coat; Musculoskeletal; Urogenital; Nervous System; Lymph Nodes; Mucous Membranes; Overall Health] 6. Select the default observation status for each system: Normal, Abnormal or Did Not Examine. [All Normal] 7. Arrange the systems in the order they will appear on the physical exam and Pet Health Report Card. 8. Click OK. 9. Click Close. Systems M This lesson demonstrates creating physical exam systems. TRAINER-LED DEMONSTRATION 1. From the Lists menu select Physical Exam and then Physical Exam Setup. [Lists > Physical Exam > Physical Exam Setup]. 2. Select New. 3. Enter the Description. [Presenting Complaint] 4. Click OK. 5. Click Close. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup Page 81

82 Chapter 8: Physical Exam Setup Observations M This lesson demonstrates creating physical exam observations. TRAINER-LED DEMONSTRATION 1. From the Lists menu select Physical Exam and then Physical Exam Setup. [Lists > Physical Exam > Physical Exam Setup]. 2. Click on the + to the left of the body system and then click on the + to the left of Observations. Select a Status. [Mouth and Teeth, Abnormal]. 3. Select New. 4. Verify the System, Observation Type and Species selected. [Mouth and Teeth, Abnormal, Undeclared]. 5. Enter the observation text. [Enter text that is not in your database files]. 6. Click OK. 7. Click Close. Chapter Summary You learned these important concepts within this chapter: Physical Exam Defaults: Setup your practice physical exam defaults. System Templates: Create and modify system templates. Systems: Create and modify systems. Observations: Create and modify observations. Page 82 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Medical Records Setup

83 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Chapter 9: Medical Notes & Correspondence M You'll learn these important concepts within this chapter: Document Template Overview Document template benefits, types, and sample listings of correspondence and medical notes you may want to create. Windows and Features for Creating Document Templates - Become acquainted with the windows to select and modify the document templates, including the toolbars to add elements that make the document easy to use such as text input fields, checkboxes, bookmarks, tables, and images. Template Properties and Save Properties Options that control how a document is saved in history, managed, and printed. Other Procedural Steps Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 83

84 Chapter 9: Medical Notes & Correspondence Document Template Overview M Document templates are reusable forms used to create medical notes and client correspondence type of documents. Document templates are just like familiar word processing programs and therefore, easy to use. The benefits of setting up templates include data entry efficiencies and consistent content amongst staff. TRAINER-LED EXPLANATION Create a Print Only, Correspondence, or Medical Note document template type. Print Only documents are considered to be one-time use documents and are not saved to the patient s history. Examples of Print Only documents might include PetDetect Collars, vaccination schedule and information or cage cards. Correspondence documents are saved to a patient s history either as the entire document or as the title only, depending on how the template was set up. Examples of Correspondence documents might include patient ID cards, insurance forms or health certificates. Medical Note documents accommodate routine and create forms for a consistent look and content. This makes searching and reduces missing information. Suggestions for medical note document templates include: Physical Exam Checklist, Surgery Notes or Urinalysis Results. These document templates show up under the Medical Notes tab on the bottom of the Patient Clipboard. Information in a medical note can be edited until it is finalized. After the document is finalized it cannot be changed, but an Addendum can be added Document Templates can be used to create a variety of documents. Here is a list of some document templates you may want to use and create: Client Education Labels Certificates Letters Forms Medical Notes breed sheets, medication information, wellness programs and pet s first year lab, cage, file, client, storage and price health, alter, vaccination, puppy/kitten class, wellness programs and brushing teeth new client, returning client, collections, lost pet, medication information, newsletter and special offers surgery authorization, health certificates, medication requests, discharge instructions, feeding schedules, staff schedules and check-in checklists exams, procedures, treatments, diagnostic results, health profiles and vital signs See Appedix document, Medical Notes Template Per Visit Type, to see a list of sample templates available on the Cornerstone Online Community and within Cornerstone. Page 84 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

85 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Windows and Features For Creating Document Templates M Review the windows and features below to create document templates. Use the Document Template List window to use an existing template as a starting point for a new template or create a new template from scratch. From the Document Template List window choose the document template action to take: New, Update, Delete, Copy, Convert or Close. Use the Cornerstone Editor window to create and modify document templates. Use the Toolbar and right-click options to insert various elements. Print Preview Paste Spell check Print Select all Zoom Undo Search Insert date and time Redo Bookmark Lock document Cut Picture Unlock document Copy Table Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 85

86 Chapter 9: Medical Notes & Correspondence TRAINER-LED DEMONSTRATION Modify the Problem-Based Samples medical note template (includes content in templates below) by inserting text input fields, bookmarks, and copy/paste the physical exam content from the Wellness Exam template into your new template. 1. Select Lists > Documents > Templates. 2. Click New or enter full or partial name of document template. [Enter Problem-Based Samples and select Update.] 3. Optional: Delete or change the header information. [Read the options for header and footer modifications, then delete the header information.] 4. Modify the template content. [Select and delete the unwanted content.] Examination - Limping History: Current Diet: Current Medications: Where are they limping? How long have they been limping? Weight Bearing?: Any Known Injury?: Attitude;? Current 4Dx Status: Exposure to other animals/wildlife? Include for all templates: Subjective: Objective Physical Exam: Assessment: Problems: Diagnosis: Plan: Examination - Skin History: Current Diet: Current Medications: Duration of Problem: Is it Seasonal?: Pruritic?: Location of Lesion/Pruritis: Diet Change?: Exposure to other animals/wildlife? Examination - Urinary History: Current Diet: Current Medications: Volume of Urine Being Produced: Straining? Frequency of Urination: Hematuria? Water Consumption: Examination - Vomiting/ Diarrhea History: Current Diet: Current Medications: Duration: Last Episode: Appetite: Consistency Stool: Consistency Vomitus: Attitude: Dietary Indiscretion 5. Optional: Leave the current document template open, but open another document template by selecting Lists > Document >Templates. [Open another document template window.] 6. Optional: Select desired document template with elements you d like to use, click Update, then select and copy content (CTRL+ C ) to paste in the other template still open. [Find Wellness Exam, click Update button, select physical exam findings table, CTRL+C, then Cancel without saving changes.] 7. Optional: Paste content into template. [Place cursor in appropriate place, then CTRL + V to paste in physical exam findings table] 8. Save the template after reviewing the next lesson. Page 86 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

87 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Template Properties and Save Options M In this demonstration you will create a correspondence document template for a client medication request. In this first stage of the demonstration, you will access the window to begin creating a document template. Use the following information to change template properties and use the various save options. TRAINER-LED EXPLANATION Click the Edit Properties button to display the Template Properties window. Name Type a Name for this document template. For this demonstration type Medication Request from Client. The document template name will be included in the history entry when this document template is used to create a patient document. Type Select the Type. Options are: Medical Note, Correspondence or Print Only. For this demonstration select Correspondence. This chart shows which document types are recorded in history and what their source icon looks like. Save Correspondence as When Correspondence is selected as the Type, choose whether the document will be saved as the Title Only (only the title and no content will be recorded in history) or as Document (the entire document will be recorded in history). The Save option is not applicable to Medical Note or Print Only. For this demonstration select Document. History (Hx) description (Optional) Type a Hx (History) description for this document template. This provides you with an additional description for this document and will be recorded in medical history. When recorded the history line will be listed with the document name, followed by the status, followed by the history description for the document. For this demonstration do not enter a history description. Sample of history description in history entry. History (Hx) Alert For uses of this document template to be marked as an alert in history, select the Hx Alert check box. Alerts help draw attention to the history entry. If viewing in black and white, the alert displays as a red line in history. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 87

88 Chapter 9: Medical Notes & Correspondence Autofinalize For the documents created from this document template to autofinalize, select the Autofinalize check box. Indicate the number of days in which the document should autofinalize. Printer 1. If this document template should print to a specific printer, select it from the list. 2. When the Template Properties are complete, click OK. Save Options 1. Save the document template by clicking on OK, Save or Cancel. For this demonstration click OK to close the document template. 2. The document template has been added to the list. Click Close to close the Document Template List window. Other Procedural Steps Inserting Tables 1. Place your cursor in the location you want to add a table and right-click. 2. From the right-click menu select Insert > Table and the New Table Parameters window displays. 3. Type the Number of Rows to be included in this table. 4. Type the Number of Columns to be included in this table. 5. Click OK. Inserting Pictures 1. Place your cursor in the location you want to add a picture and right-click. 2. Select Picture (or Picture and Description). The Select Image File to Insert window will display. 3. Locate the image (picture) you want to add to the document template and click Open. The image (picture will be added to the template). 4. To resize the height and width of the image, click on it then hover your pointing device over a handle until your cursor becomes a double pointed black arrow and grab the handle. Handles are located at the corners and middle points of the top, bottom and sides. Drag the handle to the preferred size. Repeat the resizing process until the size is good. Inserting Page Breaks 1. Place your cursor in the location you want to add a page break and right-click. 2. Select Page Break. The page break will be added at the cursor s location. Vaccination Preferences Use these steps to set up Vaccination Preferences. Vaccination Preferences allow vaccination information to be included on documents such as vaccination certificates, health certificates and other similar documents. 1. Select Controls > Defaults > Practice and Workstation > Vaccination Bookmarks. 2. Select (highlight) the vaccinations to appear on documents such as vaccination certificates, health certificates and other similar documents. 3. In the Vaccination line pattern area, select the buttons in the order in which the information should print on documents. 4. Click OK. Page 88 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

89 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Access the Cornerstone Online Community Check out all the medical note templates available for download at community.idexx.com. Importing a Document Template Import templates from the Cornerstone Online Community using the Tools menu > Import Document Templates feature. To import a document template: 1. On the Tools menu, select Import Document Templates. The Import Document Template dialog box displays. 2. If you have not already downloaded the document template to import, click the Cornerstone Community link and download the desired template file to the Downloads folder in your Cornerstone directory (e.g., C:\ Cstone\Downloads). 3. On the Import Document Template dialog box, click Browse and select the desired document template (.csz file) to import. 4. If a template with the same name already exists on your system, a message asks if you want to continue with the import. If you click Yes, a number is appended to the new template name (e.g., Eye Exam will be changed to Eye Exam (1) ). If you click No, the currently selected template will not be imported. Click Browse to select a different template or click Cancel to close the Import Document Template dialog box without importing a template. 5. Click Import Template. A message displays to inform you that the import was successful. 6. The next time you access the Document Template List window, the imported template will be available for selection in the Samples category. If the Document Template List window is open while you import the template, you will need to close the Document Template List window and reopen it in order to see the new template in the list. Document Defaults and Security Following is the defaults and security that may impact the document templates when they are used. To change the default configurations, go to Controls > Defaults > Practice and Workstation > Documents. Document Defaults Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 89

90 Chapter 9: Medical Notes & Correspondence Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Action & Decision Documents See Fig. V Medical Note Options defaults The following are Medical Note Options defaults: Display partial medical note in correspondence (classic only) Require medical notes to be finalized before patient can be checked out Number of days before auto finalize: Select the check box for Display partial medical notes in Correspondence to be able to select which information from your medical note templates to include in correspondence documents where medical note bookmarks are being used. Select the check box for Require template to be finalized before patient can be checked out if you want medical notes to be finalized prior to check out. Select the number of days before the medical notes will be automatically finalized. Sel Page 90 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

91 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Action & Decision Documents See Fig. V Document Invoice Items defaults The following are Document Invoice Items defaults: Include invoice items when printing Medical Notes Include declined and unapplied items Include invoice item Amount Include Invoice item Staff Select this check box to include invoice items that have been declined and/or unapplied when printing medical notes. Select this check box to include invoice item amounts when printing medical notes. Select this check box to include the invoice item staff when printing medical notes. Include invoice items when printing Correspondence Include declined and unapplied items Include invoice item Amount Include Invoice item Staff Select this check box to include invoice items that have been declined and/or unapplied when printing client correspondence. Select this check box to include invoice item amounts when printing client correspondence. Select this check box to include the invoice item staff when printing client correspondence. Sel Favorite document template Type the document ID of the Medical Note or Correspondence documents you would like to include on your Favorites list. (Lists > Documents > Templates). Set Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 91

92 Chapter 9: Medical Notes & Correspondence Sel = Select Set = Setup Ver = Verify Controls > Defaults > Practice and Workstation Menu Access Default Description Action & Decision Fig. V (Controls > Defaults > Practice and Workstation > Documents property) Page 92 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup

93 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Default setup document templates To set default document templates readily visible by a logged in user, go to Controls > Defaults > enter the Staff ID and click the Staff tab. Type the Doc ID or press F2 to use the Document Template List to choose the template to be used as the default setup document template. Chapter Summary You learned these important concepts within this chapter: Document Template Overview Document template benefits, types, and sample listings of correspondence and medical notes you may want to create. Windows and Features for Creating Document Templates - Become acquainted with the windows to select and modify the document templates, including the toolbars to add elements that make the document easy to use such as text input fields, check boxes, bookmarks, tables, and images. Template Properties and Save Properties Options that control how a document is saved in history, managed, and printed. Other Procedural Steps Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Electronic Medical Records Setup Page 93

94 Section 4 Appendix Page 94 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Appendix

95 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Add a Group for Monitoring Patients Who are on the Electronic Whiteboard This document provides instructions for setting up a group of items to be used for monitoring patients. Create Invoice Items Review your treatment sheet (or list of invoice items) to determine if any new services need to be created in the Invoice Item List to monitor patient care on the Electronic Whiteboard. Walk Feed (Hospitalized Patient) Water TPR Monitoring Monitor Appetite & Drinking Monitor Fluids/Check Catheter Check Bandage Radiograph Initial View Check for Diarrhea Check for Vomiting Check Incision Check Appetite Blood Draw Urination/Bowel Movement Administer Medication Add other items to customize this list for your practice... Examples displayed on Patient Orders window Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Appendix Page 95

96 Appendix Creating Smart Groups Smart groups may help your practice to become more efficient when entering routine procedures on invoices, estimates or Patient Visit Lists. Using the invoice items you have chosen to comprise your Patient Monitoring Group, create the group and make it smart where needed. Procedural Step Summary 1. From the Cornerstone menu, select Lists > Invoice Item. 2. Click New. 3. Accept the item ID provided or enter one of your choosing. 4. Select the item type of Group. 5. From the Information tab, enter a Hospital description, which appears in the Invoice Item List, in reports and in the patient s medical file. 6. Optional: Enter a Client description. 7. Under Classification, select the Primary classification for the item. 8. A Subclass may be selected, but is not required. 9. Enter the Default revenue center to be used for this item. Double click or press F2 to search, if needed. 10. Leave the default Status of this item as Active. 11. Optional: If appropriate, select the Miscellaneous item check box. 12. Select the Group Items tab. 13. Add invoice items to the group. Double click or press F2 to search the Invoice Item List, if needed. Inventory items, service items, group items, pick items and dispensing items can be added to a group item. 14. On an item s line, click the No button in the Smart? column to make the item smart. 15. If this item is specific to a species, select the appropriate species from the list. Selected species are highlighted in blue. To select multiple species, press and hold the Ctrl key while selecting each species. Note: You must either select all species rows, or no more than four species. 16. If this item is specific to a sex, select the appropriate Sex from the list. Selected sexes are highlighted in blue. You must select all sexes or no more than two. Press and hold the Ctrl key while selecting each Sex. 17. Select the Only pets with ages: check box if this item should only be applied if the patient is within a certain age range. Enter the appropriate age ranges. 18. Select the Only pets with weights: check box if this item should only be applied if the patient s weight is within a certain range. Enter the appropriate weight range for this item. Remember to consider weights that are between whole numbers (e.g., pounds). 19. To prompt for a weight entry if it is not on file, select either the Ask for weight check box or the Ask for weight if none was recorded in last 30 days check box. 20. Select the Ask user before adding this item check box if this item is not a routine part of the procedure. This selection would cause a prompt to appear before this item is added to the estimate, Patient Visit List or invoice. The prompt would allow you to select Yes or No to add the item. 21. Select the Stop and ask for quantity check box if the item requires a quantity greater than one. This feature is helpful for items such as pharmaceuticals or those that are based on time increments (ex. Comb Out item). 22. The Group item pricing area allows you to change the pricing structure when these items are applied as part of a group. If you choose to select Mark Up or Mark Down, you can then select whether the price should be adjusted by a certain percentage or amount and then enter the appropriate value. Note: Click the Dollar Sign button to view how the price change is calculated. 23. Select the Ignore Minimum Price check box if the price adjustment should disregard the minimum price. 24. Click OK to save the smart settings. 25. Complete steps to establish smart settings for other items. 26. To change the Printing option, select an option from the list. 27. Select the Travel tab. 28. Select any travel sheets upon which this item should be listed. Multiple travel sheets may be selected. 29. When the information regarding the setup of this service item is complete, click OK to save. The invoice item has been set up and appears in the Invoice Item List. 30. Click Close to exit. Page 96 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Appendix

97 Patient Visit Workflow Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Appendix Page 97

98 Appendix IDEXX Cornerstone * This is a sample of the template that will be provided to you in Microsoft Word format. Project Plan Template Project Champion: Project Lead: Core Team: Goal/ Task Goal/ Task ID Goal/Task Start Date End Date Status (Not Started, In Progress, Complete) Responsibility/Notes Goal Increase our practice s (enter goal) from % / $ amount from (date) to % / $ amount by (date). 1.1 Assess and Commit: T A S K Train and Change: Once gaps are identified, training is used to bring staff and management to new level of proficiency Measure and Manage: Setting goals that can be quantified has a powerful influence on the success of any transition. Page 98 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Appendix

99 Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup IDEXX Cornerstone * Sample Project Plan Project Champion: Dr. Jones Project Lead: Dr. Jones Core Team: Dr. Jones, Dr. Carson, Sue Bee Goal/ Task Goal/ Task ID Goal/Task Start Date End Date Status (Not Started, In Progress, Complete) Responsibility/Notes Goal Implement usage of electronic medical records, create practice standards of care. 1.1 Assess and Commit: Outline Protocols and Visit Workflows include list of invoice items for each protocol, workflow Outline intended use of Cornerstone Electronic Medical Records include smart groups, medical note templates, physical exam. T A S K Set up Cornerstone Electronic Medical Record features. Train and Change: Once gaps are identified, training is used to bring staff and management to new level of proficiency Core Team - Test electronic medical records Core Team - Modify setup of electronic medical record features, modify protocols, modify workflows Core Team - Retest electronic medical records Provide staff training for use of electronic medical records. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Appendix Page 99

100 Appendix Goal/ Task Goal/ Task ID Goal/Task Start Date End Date Status (Not Started, In Progress, Complete) Responsibility/Notes T A S K Measure and Manage: Setting goals that can be quantified has a powerful influence on the success of any transition. Measure patient compliance documented in electronic medical records Create plan for improving patient compliance Create plan for ongoing measures and improvements. Benefits: Improve documentation of patient medical records, increase use of electronic functionality and reduce use of patient files, hard copies and paper, improve patient compliance through standardized protocols and visit workflows. Page 100 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Appendix

101 IDEXX Cornerstone Chartless Setup Checklist CLIENT/PATIENT INFORMATION RECOMMENDATIONS 1. User Defined Prompts: Consider creating user defined prompts to create fields for information that does not already exist in the client or patient record. User defined prompts can also be set as alerts. Client Prompts: Preferred Doctor, Client Alert Patient Prompts: Medical Condition, Patient Alert, Temperament, Special Diet, Vaccine Reactor, Allergic To MEDICAL HISTORY RECOMMENDATIONS Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup 1. List Top 10 Reasons for Visit: Create a list of your top ten reasons for visit. Use this list to ensure that all Cornerstone features are setup to support your protocols for the most common visits. 2. Review/Modify Reasons for Visit: Review reasons for visit. Create reasons for visit for the top 10 reasons for visit if not already listed. Attach alerts to remind staff of information they should collect from or provide to the client. Documents can also be attached to print at check-in or check-out. (Controls > Reasons for Visit) 3. Create Smart Groups: Create smart groups for your top 10 reasons for visit. Smart groups will establish your protocol and ensure charges are not missed. Pick lists may also be used in smart groups. (Lists > Invoice Item) 4. Create Document Templates: Create medical notes and documents (correspondence or print only) for each reason for visit. (Lists > Documents > Templates) Medical note templates will standardize the information recorded for each visit in the patient s file. Ensure template include fields for SOAP or HEAP notations and links to enter vital signs, problems, and diagnoses. Documents can be created for consent forms, discharge instructions, and client education which can be electronically signed and saved to the patient s file. 5. Review/Modify Problems: Review/modify the problem list. This will ensure the majority of common problems will be on the list to be added to the patient s file as needed. By reviewing now, it will eliminate time entering new problems during exam time. (Controls, Problems, Problem List) 6. Review/Modify Diagnoses: Review/modify the diagnostic code list. This will ensure the majority of common diagnoses will be on the list to be added to the patient s file as needed. By reviewing now, it will eliminate time entering new diagnoses during exam time. (Lists, Diagnostic Codes) 7. Review/Modify Callback Reminders: Review/modify callback reminders attached to invoice items for each reason for visit to ensure callbacks are performed and documented in the patient s file. (Lists > Invoice Item) 8. Review/Modify & Attach Departing Instructions: Review/modify the departing instructions and attach to invoice items to ensure consistent information is provided to clients regarding service and inventory items where appropriate. (Lists > Departing Instructions) 9. Review/Modify & Attach Prescription Instructions: Review/modify prescription instructions and attach to invoice items where appropriate. This will create efficiency when creating prescription labels for medications that have standard dosing instruction. (Lists > Prescription Instructions) 10. Review Diagnostic Integration Options: IDEXX SmartLink Services can advance the standard of medical care in your practice. It will help you provide better medicine and increase efficiency which lead to better business and increased client loyalty. Lab results and digital radiography can be directly downloaded to the patient s file. Contact your System Consultant for more information on integration options for your practice. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Appendix Page 101

102 Appendix 11. Create Compliance Protocols: Create compliance protocols for your top reasons for visit to measure compliance rates and review missing revenue opportunities. Use the compliance results to determine opportunities for staff education. (Reports > Compliance Assessment Tool > Protocol Setup Wizard) Use the following chart to help review your current chartless feature setup to determine where there are gaps. Medical Protocol Patient Alerts Compliance Alerts Reason for Visit Medical Note Templates Consistent Use of Feature with Description Example: Wellness Exam Yes No Yes No SOAP Notations No Vital Signs No Problems/Diagnosis No Report Card Yes Smart Group Documents Call Backs Departing Instructions Prescription Instructions Diagnostic Results Lab Radiographs Compliance Protocol No No Yes Yes N/A Yes No No Page 102 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Appendix

103 IDEXX Cornerstone * Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Follow-Up and Next Steps We want to ensure your implementation and success. In order for us to do so, each Friday until implementation is complete, send one to [email protected] containing: Subject: EMR Setup Status, Practice Name 1. Attach your updated project plan 2. Other status info: Completed action items for the week Next week s tasks Challenges or obstacles that you encountered At each month end until implementation is complete, include your average invoice from: 1. Reports > End of Period > End of Month. 2. Click on the last month closed. 3. Click on Statistics by Staff Report Closed Invoices. Ask for the resource, Guide to Becoming Paperless or Paper-light. This helpful guide includes project phases, phase steps, a checklist, and motivational words and tips from your peers. Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Appendix Page 103

104 Skill Assessment Practice Name: Your Name: Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Coaching Course Skill Assessment Completion Date: Instructions: After completing your training, please read each of the following skill assessment statements and evaluate your ability to perform each task. Mark only one x for each skill statement. Can Perform Can Perform but NOT Using Cannot Perform Not Applicable 1. I can locate the Cornerstone Workflow. 2. I can locate the technology items that would be useful for a practice with electronic medical records. 3. I can locate the Security Settings document. 4. I can access and set default settings from the Lists menu. 5. I can access and set default settings from the Controls menu. 6. I can create and update a dispensing item. 7. I can create and update a pick item. 8. I can create and update a smart group. 9. I can explain the use of pick items and smart groups. 10. I can attach special actions to invoice items. 11. I can attach reminders to generate and satisfy to invoice items. 12. I can set up vaccine tag information for invoice items. 13. I can set up treatment categories and frequencies. 14. I can set up wards/locations and treatment areas. 15. I can create and update physical exam systems templates. 16. I can create and update physical exam systems and observations. 17. I can set up vital signs. 18. I can create a document template. 19. I can insert an invoice item into a document template. 20. I can insert a table into a document template. 21. I can insert a document template to autofinalize in a specific number of days. 22. I can edit and/or delete a default header and/or footer in a document template. 23. I can set properties for a document template. 24. I can mark a document template as inactive. Please return this Coaching Course Skill Assessment using one of Results of the Skill Assessment the following methods: Can Perform Fax this information to: Learning & Performance Department at Can Perform but not Using Cannot Perform Mail this information to: IDEXX Computer Systems Not Applicable Attn: Learning & Performance Department 2536 Alpine Road Eau Claire, WI Page 104 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Skill Assessment

105 IDEXX Cornerstone * Coaching Course Evaluation Cornerstone 8.1 Electronic Medical Records & Whiteboard Setup Coaching Course Evaluation We Value Your Opinion! - Tell us what you think about the Electronic Medical Records & Whiteboard Setup Coaching Course Evaluation. Practice: Trainer: Date: Feedback received from you regarding the training is vital to our continued improvement. Course Description This course is ideal for individuals responsible for the setup of electronic medical records and/or the Electronic Whiteboard. You ll learn of electronic medical records and whiteboard as well as other related setup tasks such as: Patient Visit Overview Electronic Medical Records Default Settings Invoice Item Setup Electronic Whiteboard Setup Medical Notes and Correspondence 1. How likely would you be to recommend an IDEXX Cornerstone Coaching Course to a friend or colleague? 2. Why did you select this rating? 3. Tell us how we did with: Did not meet expectations Met Expectations Course content matching the course description Professional looking course materials Providing course materials that were valuable Arriving well prepared & using appropriate examples Using effective communication skills Answering all of my questions effectively Enabling our practice to expand our use of Cornerstone s features Providing good value for the cost Comments: 4. Tell us what you think about the length of the course: Too short Too long Just right Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Evaluation Page 105

106 IDEXX Cornerstone * Coaching Course Evaluation 5. Did you follow along with the participant workbook during the course presentation? Yes - I followed the participant workbook the majority of the time. No - I didn t use the participant workbook. Sometimes - I used the participant workbook some, but not most, of the time. 6. When prompted, did you complete the training exercises in the Cornerstone Training Files? (You may have shared a computer with another participant to complete the training exercises) Yes - I/we completed the majority of the training exercises. No - I/we didn t complete the training exercises. Sometimes - I/we completed some, but not the majority, of the training exercises. N/A - I/we used our real files instead of the training files. 7. What was the most valuable aspect of this course? 8. What suggestions do you have for future revisions of this course? 9. How many participants from your practice attended some, or all, of this course? or more 10. What is your position in your practice? Veterinarian Veterinarian/Practice Owner Office/Practice/Business Manager Technician/ Nurse Reception/Client Services Other (specify) Thank you! We appreciate your feedback. Testimonial Permission (optional): (Please check the box below) Please have an IDEXX Computer Systems Representative contact me to discuss featuring my comments in promotional materials. Please Print: Your Name: Practice Name: Practice City, State: Practice Telephone #: Please return this Coaching Course Evaluation using one of the following methods: Fax this information to: Learning & Performance Department at Mail this information to: IDEXX Computer Systems Attn: Learning & Performance Department 2536 Alpine Road Eau Claire, WI Page 106 Cornerstone* 8.1 Electronic Medical Records & Whiteboard Setup Evaluation

107 Support: Sales: idexx.com/cornerstone 2011 IDEXX Laboratories, Inc. All rights reserved.