The Primary Care Clinic at LPCH is beginning a new partnership with the Gardner Family Health Network. November 20, 2012 is our first official day as the Gardner & Packard Children s Health Center. This tutorial provides an introduction to NextGen, which will gradually replace Cerner as our Electronic Health Record for Primary Care. Part 1 of the tutorial addresses Record Review. Part 2 will cover eprescribing in NextGen. 1
In this section of the tutorial, you will learn how to launch NextGen, log in, view your daily schedule, search for a patient, and review the medical information stored in the system. It may be helpful to open NextGen and explore as you move through the tutorial. A printable version of the tutorial slide set is available on the PPC website, ppc.stanford.edu 2
Each workstation in Primary Care should have a NextGen EHR icon on the desktop. If you do not see the NextGenEHR icon, look for a red and white button that says 2x in the lower right hand corner of the screen Double click to open NextGen 3
When prompted to log in, enter the username and temporary password that were sent to you by email. The log in screen may look different from the one shown here. You will be prompted to change your password once you log in for the first time. 4
Type or select your name when you see the Select Provider window. During the transition period around our November 20 start date, if your name is not yet included in the NextGen Provider list, select Stuart, Anne Elizabeth. Once your name has been added to the Provider list, select yourself when you log in. If you see a pop-up window that alerts you that you are not listed as a resource in the system, ignore the message for now. 5
At the top of the screen, in the Tool Bar, you will see buttons to take you to various parts of the electronic record. The buttons we will use in clinic are those for Inbox Patient Lookup History As you become familiar with NextGen, you can customize your Tool Bar by adding and removing buttons. 6
Often, the first thing you will want to do in clinic is look at your schedule for the day. When you first log in to NextGen, the Inbox may be open automatically. If not, Use the Inbox button at the top of the screen. 7
The Resource button allows you to select different providers schedules to view. To see the Acute Care Clinic schedule, use the Resource button, and Select Acute Care Resident. To see a continuity resident s schedule, Select the name of the resident. Next Gen allows you to bring up both the Acute Care schedule and as many individual resident schedules as you would like to view simultaneously. You can sort by provider or time of visit. 8
From the Inbox, you can go into an individual patient s record directly by double clicking on the patient s name in the schedule. Alternatively, you can use the Patient Lookup button in the Toolbar, which will bring up the window on the next slide. 9
To find a particular patient, search by last name/first name or by medical record number. To search by MR number, use the drop down list in the Search By field (circled in orange). You can also search by the patient s LPCH Medical Record number by setting the drop down section to Other ID Nbr 10
At this point, if you are exploring NextGen live while going through the tutorial, you will want to choose a Test Patient whose records you can review in some detail. On the Patient Lookup screen Enter Patient in the Last Name field, and select Find in the lower left hand corner of the window. Select a test patient from the search results list. The examples that follow in the tutorial are for a test patient named Toddler Patient. 11
So far, we ve looked at the Tool Bar buttons for the Inbox and Patient Lookup The History button takes you into an individual patient s electronic record. 12
Once you are inside a patient s electronic record, you will see a window that looks like this. Note the three tabs at the top of the window: Patient History, Patient Demographics, Categories In the window that s shown, the Patient History tab is selected. The Patient History section is organized by date. The Categories section groups documents by type. The next slide summarizes what types of information can found in each section of the chart. 13
In general, the Patient History section contains information relevant to the current visit to clinic. The Categories section houses data from previous visits. Use the Categories section as you use the Scanned Docs section in Cerner. While the Gardner-Packard clinic is located at 730 Welch Rd., we will continue to rely on scanned documents as our primary form of record keeping. 14
In the Patient History section, to see vital signs, growth charts, medication lists, and other information entered by the medical assistants, click on the folder icon for the date of the visit, then click on one of the blue and white template icons. A note on the abbreviations here: OV means Outpatient Visit, GFHN = Gardner Family Health Network, Ng means NextGen. The Intake form is what the MAs will use to enter data when checking in patients. Click on any one of these to enter the Patient History section of the EHR. 15
Once you have opened an electronic template in the Patient History Section, you can use the black and white tabs to move among the different types of files. This is the Visit Summary screen. To see growth charts, click on the link to Height/Weight and or BMI. 16
In the Visit Summary screen, you can change the Order View field to see details of different aspects of the patient chart. In this slide, Order View is set to show details of Growth measurements. In the next slide, the Order View is set to Immunizations. 17
18
To see clinic notes and other documents that have been scanned into NextGen, use the Categories Tab, which separates different types of documents into groups. Open the Progress Notes folder to look for a specific visit note. NOTE: Only notes completed on or after November 20, 2012 will be scanned into NextGen. To see notes completed prior to November 20, use Cerner. 19
As an example, this screen from the Categories section shows a scanned Ages and Stages Questionnaire score sheet for a patient seen in another Gardner clinic. At Gardner Packard, we will use our standard structured encounter forms and Teaching Encounter forms for both acute and well child visits. These will appear in NextGen as the ASQ example appears here. 20
To review: After launching NextGen from the desktop, log in and select your provider name. Use the Inbox to view daily provider schedules Use the Patient Lookup button to search for a specific patient, by name, Gardner-Packard MR number or LPCH MRN The History Button takes you into the detailed patient record. Use the Patient History tab for vital signs, growth measurements and other data for the current visit. Use the Categories tab to see scanned documents from previous visits. 21