How To Use This Manual... 4 User Interface Elements... 5 User Actions... 5 Instructional Markup... 6

How To Use This Manual... 4 User Interface Elements... 5 User Actions... 5 Instructional Markup... 6 Understanding Oscar... 7 Oscar Electronic Medical Records (Oscar EMR)... 7 Oscar EMR is an Open Source Software... 7 Oscar EMR Has a Strong Community of Users and Supporters... 7 There Are Many Additional Resources for Oscar EMR... 7 Understanding the Client Server Relationship... 8 Computer Network... 8 Server... 8 Client... 8 Web Browser... 8 Firefox Internet browser... 8 Accessing Oscar... 10 Installing Firefox Internet Browser... 10 Accessing Oscar... 10 Entering and Editing Clinic Details... 11 On Boarding Clinic Employees (Provider)... 11 Creating a provider profile... 12 Creating a profile for a Medical Office Administrator (MOA)... 12 Creating a profile for a receptionist... 12 Creating a profile for a doctor (permanent or Locum)... 12 Editing a Profile... 13 Understanding Oscar s Security... 13 Assigning a role to a provider profile... 14 Choosing passwords and pin codes... 14 Adding a login record to a provider profile... 15 Editing, deleting or searching a provider s login record... 15 Modifying the status of a provider... 16 Reinstating a locked out provider... 16 Troubleshooting login issues with a Login Report... 16 Managing Provider Preferences... 17 Setting a provider signature... 17 Setting a provider s clinic hours... 17 Changing a password... 17 Building a Provider Schedule... 18 Understanding time blocks... 18 Setting clinic holidays and closures... 18 Create custom template codes... 18 Creating a clinic schedule template... 19 Editing a schedule template... 20 Creating a new provider schedule... 20 Creating appointment types... 20 On Boarding Patients (Demographic)... 22

Navigating a Patient s Master File... 22 Searching for patient master files... 22 Creating a patient master file... 23 Editing a patient master file... 24 Changing the status of a patient file... 25 Joining patient master files... 26 Unjoining patient master files... 26 Managing the Clinic Schedule... 27 Creating and editing schedule groups... 27 Creating a new group... 27 Modifying a group... 27 Navigating Schedule Views... 28 Managing Appointments... 29 Creating a new appointment... 29 Searching for an available appointment... 30 Modifying an appointment... 30 Editing an appointment... 30 Deleting an appointment... 30 Canceling an appointment... 31 Moving an appointment... 31 No show appointment... 31 Recurring appointment... 32 Managing appointment status... 32 Viewing patient appointment history... 33 Determining a Patients British Columbia Medical Services Plan (BC MSP) Eligibility... 33 Managing Patient Lab Results and Documents... 33 Interfacing with an electronic lab service... 33 Working with the Inbox... 34 Uploading electronic HL7 lab reports (HL7)... 34 Uploading scanned or faxed lab reports (DOCS)... 35 Viewing un- assigned docs... 35 Assigning un- assigned docs... 36 Acknowledging lab documents... 36 Forwarding lab documents to another provider... 37 Filing lab documents... 37 Searching for lab documents... 37 Adding scanned or faxed documents to a patient file... 37 Viewing a lab documents from a patient master record... 38 Understanding Ticklers... 38 Creating a new Tickler... 38 Creating a Tickler Group (TCI)... 39 Following up a Tickler... 39 Managing Electronic Medical Forms... 40 Managing the Health Form library... 40 Selecting commonly used forms... 40 Managing the e- Form library... 41 2

Adding to the e- Form library... 41 Viewing and editing eforms... 41 Downloading eforms directly from the repository... 42 Customizing and modifying e- Forms... 42 Managing the edoc library... 42 Uploading distributable documents... 42 Viewing available documents... 43 Managing patient measurement tables... 43 Accessing the measurement customization menu... 43 Adding a new measurement type... 43 Creating a measurement group... 43 Working with the Electronic Patient Encounter Chart (echart)... 45 Accessing the echart from a patient master file... 45 Accessing the echart from an active appointment... 45 Managing the Cumulative Patient Profile (CPP)... 45 Viewing and editing items in the CPP... 46 Entering allergies... 46 Managing prescriptions... 46 Managing measurements... 46 Preparing consultations... 47 Viewing and managing consultations... 47 Creating a New Health Form... 47 Reviewing and editing Health Forms... 47 Creating a new e- Form... 47 Viewing e- Form history... 47 Editing an e- Form... 47 Deleting an e- Form... 47 Writing a patient letter with the Rich Text Letter Editor... 47 Creating a new Tickler... 47 Creating recalls and prevention schedules... 47 Understanding Oscar s prevention schedules... 47 Creating a recall schedule for vaccines... 47 Recalling a patient for PAP, and mammogram exams... 47 Creating a PSA recall schedule... 47 Creating a FOBT recall schedule... 47 Chronic Disease Management (CDM)... 47 Understanding the Diagnosis Registry (DR) and Chronic Disease Management (CDM)... 48 Creating a CDM flow sheet... 48 Tracking patient reminders and recalls... 48 Using graphs to view progress... 48 Mapping lab measurements from lab results to the CDM... 48 Managing Billing (Billing MSP)... 49 Understanding the Billing Pick List (aka: Oscar BC Billing)... 49 Customizing the Billing Pick List... 49 Creating billing code associations... 50 Billing... 51 Billing from the echart... 51 3

Billing from an appointment... 51 Billing from a Patient s Master File.... 51 Creating a new billing (The Billing Pick List)... 51 Submitting bulk billing with BC Quick Billing... 53 Billing a patient or third party directly (Private Billing)... 53 Creating private billing codes... 54 Creating a private Billing Pick List... 55 Billing for WCB claims... 55 Completing a WCB- 8 form... 56 Completing a WCB- 11 form... 56 Completing WCB forms from the echart... 56 Billing Insurance Corporation of British Columbia (ICBC) claims... 57 Managing reciprocal (Intra- Provincial) billing... 57 Managing Patient Pay Opted- Out billing... 57 Receiving Private Bill Payments... 57 Debiting MSP... 58 Managing Teleplan (MSP Billing Submissions)... 58 Managing Teleplan Account Settings... 59 Preparing submissions... 59 Transmitting submissions... 59 Reviewing and Correcting Submission Errors... 60 Reviewing MSP Remittances... 60 Correcting and Resubmitting MSP Rejections and Errors... 60 Creating Billing Reports... 61 Creating a MSP Rejection Report... 61 Handling reconciliation reports... 61 Reviewing accounts receivable... 61 Creating write off reports... 61 Creating a report of unbilled patients... 61 Creating Clinical Reports... 62 Understanding how reports improve the clinical process... 62 Generating a day sheet... 62 Generating a report for flu shot billing... 62 Creating a report for the disease registry... 62 Generating a list of no show appointments... 62 Sending and Receiving Secure Messages... 62 Sending broadcast messages... 62 Sending a message to a specific provider... 62 Attaching a message to a patient file... 62 Resources... 62 How To Use This Manual 4

This manual is divided into major modules relative to modules in Oscar EMR. Each module contains tasks and each task has steps. Every module, task and step of a task is written chronologically. A task may fail completion because a previous step or a previous task was not completed. If completion of a task does fail, review the previous tasks or steps for any missed instructions. This manual should be read consecutively from start to finish at least once. User Interface Elements Each task may refer to an element in Oscar s user interface that will require an interaction. The following table is a listing of potential element names followed by a definition and an image. Element / Field Description Image Text Field/Box A rectangular box that accepts one line of user entered text. Text Area A rectangular box that accepts more than one line of user entered text. Dropdown Menu Selection List Menu A selection menu that hides and expands selection options. A selection menu that displays all selection options. A listing of actions or tasks a user can click on. MENU Item One Item two Pop- up Calendar A selection calendar that pops up when it s icon is clicked on. Checkbox Allows a user to select one, more or no options. Checked Unchecked Radio Button Allows a user to select only one option Selected Unselected Link Text that contains directions to another page. This is a link Mouse Pointer A visual image of a mouse in the user interface. Field Set Menu Group A box of related elements grouped together. A box of related menus grouped together. User Actions Each task may describe some of the following actions to be taken in Oscar s user interface: Click A single press of the left mouse button. Double Click Two consecutive presses of the left mouse button. Right Click A single press of the right mouse button. 5

Hover When the mouse pointer is placed over a user interface element. Select Single click on an element or text to indicate that it has been selected. Check To click on checkbox to enable a checkmark. Type To use a keyboard to enter text into text fields. Press To press on a key or key command on a keyboard. Instructional Markup Instructional markup highlights words and subjects to attract focus from the reader. When words are bolded this indicates that the exact words will be found in Oscar s user interface. Italicized words indicate an important note or supplemental information. A note is often prepended with an arrow shaped bullet. When a task refers to another task in the manual the task title is bolded and italicized. 6

Understanding Oscar OSCAR stands for Open Source Clinical Application and Resource. EMR stands for Electronic Medical Records. Refer to Appendix 1: Anatomy of an Oscar appended to the end of this manual. Oscar Electronic Medical Records (Oscar EMR) OSCAR is a proven Electronic Medical Record (EMR) designed to help improve health care from individual to population health levels while reducing costs. OSCAR, which currently supports over 1.5 million patients across Canada, offers an extremely versatile, browser- based, EMR with high clinical functionality and advanced research capabilities. This highly customizable EMR has no licensing fees, and its low cost of ownership makes OSCAR one of the most efficient and affordable EMR solutions in Canada for practices of all sizes and specialties. Ø Further information about Oscar EMR can be found at: www.oscarmcmaster.org Oscar EMR is an Open Source Software OSCAR is a Free Open Source Software product licensed under the GNU General Public License. Open Source software is non- proprietary, has no licensing fees and is therefore able to evolve rapidly by incorporating the collective thoughts, ideas and innovations of its users across the nation and beyond. Oscar EMR Has a Strong Community of Users and Supporters www.oscarcanada.org There Are Many Additional Resources for Oscar EMR www.oscarmanual.org 7

Understanding the Client Server Relationship Computer Network A computer network or data network is a telecommunications network that allows computers to exchange data. The connections (network links) between networked computing devices (network nodes) are established using either cable media or wireless media. The best- known computer network is the Internet. Server A server is a system (software and suitable computer hardware) that responds to requests across a computer network to provide, or help to provide, a network service. Servers can be run on a dedicated computer, which is also often referred to as "the server", but many networked computers are capable of hosting servers. In many cases, a computer can provide several services and have several servers running. Client A client is a piece of computer hardware or software that accesses a service made available by a server. The server is often (but not always) on another computer system, in which case the client accesses the service by way of a network. [1] The term applies to programs or devices that are part of a client server model. Web Browser A web browser (commonly referred to as a browser) is a software application for retrieving, presenting and traversing information resources on the World Wide Web. An information resource is identified by a Uniform Resource Identifier (URL) and may be a web page, image, video or other piece of content. [1] Hyperlinks present in resources enable users easily to navigate their browsers to related resources. Ø Definitions taken from http://en.wikipedia.org Firefox Internet browser Firefox is an Internet browser - or Web Browser - that is highly recommended for connecting to Oscar s resources located on the server in a network. 8

Figure 1: A server based network 9

Accessing Oscar Oscar can be accessed from inside a clinic - and remotely by utilizing Firefox Internet browser on any client computer. Although Oscar is compatible with all Internet browsers Firefox is highly recommended. Installing Firefox Internet Browser If Firefox is already installed on a client computer then skip this task 1. Download Firefox from http://www.mozilla.org/en- US/firefox/new/ 2. Follow the Firefox online instructions for installation onto a client computer. Accessing Oscar 1. Open Firefox. 2. Type the address for Oscar EMR into the Firefox address bar. https://[oscar s network IP]:[Oscar port number]/[oscar context] Oscar network IP (internal): Oscar network IP (external): Oscar port number: Oscar context: Internal = External = Ø An Oscar Service Provider (OSP), installer, or trainer should provide an internal and external address for Oscar. 3. Press enter. 4. Add the resulting Oscar login page to Firefox bookmarks for future reference. a. Click the star icon located on the right side of the address window. 5. Type the login credentials into fields found on the left of Oscar s main login page. a. User Name type a login name b. Password type a password c. Secondary Password type a PIN code 6. Click sign in. 10

Entering and Editing Clinic Details Clinic details are the clinics letterhead and contact information for all outgoing communication. 1. On Oscar s main menu, click admin. 2. On the Administrative Page under the Misc menu, click Clinic/Agency Address. 3. On Manage Clinic Details input the required information. a. Clinic Name: full legal name of the clinic b. Clinic Address: clinics mailing address c. Clinic City: city of the mailing address d. Clinic Postal: postal code of the mailing address e. Clinic Phone: phone number which labs and billed clients can contact you on. f. Clinic Fax: fax number which labs, and patient data can be faxed to. g. Clinic Province: province the clinic operates in. 4. On Manage Clinic Details, click submit On Boarding Clinic Employees (Provider) The following tasks in this module describe the minimum requirements for creating a provider in Oscar. The main tasks involved in creating a new provider are: Creating a profile. Assigning a role to a provider. Adding a login record to a provider. Once a basic provider record is created, the following tasks set the providers details according to a role in the clinic: Setting provider preferences. Creating a provider schedule. Ø Before adding a new provider it is important to determine what role the provider is authorized for in the clinic doctor, receptionist, MOA or temporary. 11

Creating a provider profile 1. On Oscar s main menu, click admin. 2. On the Administrative Page under the Provider menu, click Search/Edit/Delete Provider Records. 3. On Search a Provider leave Last Name selected and the search field blank and then click Search. 4. Write down the highest provider ID number from the search results. 5. Click back. 6. On the Administrative Page under the Provider menu, click Add a Provider Record. 7. On Add a Provider type the following required information: a. Provider Number by increasing the highest provider number found in your previous search results by 1. Ø There are several additional options for organizing provider ID numbers. b. Last Name the providers last name. c. First Name the providers first name. d. Type the providers role in the clinic The following sub tasks demonstrate the creation of common profile types. If the Add a Provider window has been closed, complete the task Editing a Profile (below) before proceeding. Creating a profile for a Medical Office Administrator (MOA) 1. On Add a Provider: e. From the Type dropdown menu, select receptionist. f. In the Sex (F/M) text field, type your preference: Female or Male. 2. On Add a Provider, at the bottom, click Add Provider Record. Creating a profile for a receptionist 1. On Add a Provider: e. From the Type drop down menu select receptionist. f. In the Sex (F/M) text box type your preference Female or Male. 2. On Add a Provider, at the bottom, click Add Provider Record. Creating a profile for a doctor (permanent or Locum) 1. On Add a Provider: e. From the Type dropdown menu, select doctor. f. In the Specialty text box type the practitioners specialty. Ø For example Family Medicine or FM. 12

g. In the Sex (F/M) text box type your preference Female or Male. h. Provincial Billing/MSP - type the doctor s MSP practitioner number. Ø A five digit number which identifies the practitioner (04356) i. Billing - type the doctor s MSP payment number. Ø In most cases this will be the same number as the MSP practitioner number. j. College of Physicians and Surgeons Identification (CPSID) type the doctor s CPSID number. 2. On Add a Provider, at the bottom, click Add Provider Record. Editing a Profile 1. On Oscar s main menu, click admin. 2. On the Administrative Page under the Provider menu, click Search/Edit/Delete Provider Records. 3. On Search a Provider choose Search Criteria - Last Name or Provider No. 4. Type a provider s Last Name or Provider Number into the search text field. 5. Click Search. 6. On Provider: the following records from the Results table, click on the desired providers ID number. 7. On Update Provider Record, proceed to edit any field in the profile. Understanding Oscar s Security Usernames, passwords and secondary PINs are provided for every Oscar user. Disclosing passwords and sharing accounts is the number one security concern for protecting patient data. Always remember to log out of an account. Oscar encrypts data travelling between a client computer and a server using a protocol called HTTPS. This encryption is useful for providers who wish to use Oscar in remote locations. Never disclose the remote address to anyone unauthorized. Oscar s provider roles ensure that unauthorized providers cannot view patient data. Each user is assigned a role consistent with their responsibilities in the clinic. For instance, a temporary office administrator is never assigned the role of doctor. Oscar will temporarily lock out a user who incorrectly types their password or username 3 times. Wait until the lock out expires, or have an administrator unlock the account. 13

The second level PIN passcode is assigned to users who plan to access Oscar remotely. This PIN code adds an additional level of security to Oscar s already secure communications environment. When creating a login record for another provider, use a generic password, and then encourage the provider to change the generic password to something more personal during the first login session. Set expiry dates for passwords in a provider s login record. This ensures that passwords are always fresh, and forgotten or inactive logins are automatically cancelled. When a provider no longer works in the clinic (temporarily or otherwise) ensure that their status in the provider record is updated to inactive. Do not delete or remove any providers or provider data. Assigning a role to a provider profile Most often, the reason a new provider s login credentials do not work is because a role has not been assigned. 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Security menu, click Assign Role to Provider. 3. On the Provider- Role List under the Role column select a role from the dropdown menu. 4. On the Provider- Role List under the Action column, click Add. a. To change a role, click Update b. To delete a role, click Delete c. To add an additional role, select a role from the Role dropdown and then click Add. Ø A senior MOA is often assigned both doctor and admin roles. Choosing passwords and pin codes Passwords must be minimum 6 characters long Must contain capital letters, lower case letters and numbers PIN codes must be four numbers long Choose a strong password that cannot be guessed. I.E: PasSworD123 Ideal usernames are the first letter of a first name and a last name. I.E: Joe Cool gets a username of jcool 14

Adding a login record to a provider profile All providers in a clinic are required to have an individual login record. 1. On Oscar s main menu, click admin. 2. On the Administrative Page under the Security menu, click Add a Login Record. 3. On Add a Login User type the login data. a. User Name: providers login user name (ie: jcool). b. Password: providers generic password (ie: PasSworD123) c. Confirm: type the password again to confirm d. Provider No: choose the provider profile from the dropdown menu e. Expiry Date (optional): check and type a date for when the login record is to expire. Ø The provider will need to change their password on this date. This is a highly recommended security practice. f. PIN: type a 4- digit secondary passcode. g. Confirm: type the PIN number again to confirm. 4. On Add a Login User, click Add Record. 5. On Success, click back. Editing, deleting or searching a provider s login record 1. On Oscar s main menu, click admin. 2. On the Administrative Page under the Security menu, click Search/Edit/Delete Security Records. 3. On Search Security Records choose Search Criteria User Name or Provider Number and then type the corresponding search parameters into the search field. 4. On Search Security Records, click Search. 5. If there are no - or incorrect - search results on the Security page, click Back and then on Search Security Records type new Search Criteria. 6. On Security in the Results table, click on the User Name that requires editing. 7. On Update a Security Record edit the required fields or click Delete Record. Ø On Update a Security Record there is an option to enable/disable PIN code requirements. To disable the requirement for a local user to type in a PIN code for every login, uncheck the Pin (local) Enable option. It is advisable to leave the Pin(remote) Enable option checked. 8. On Update a Security Record, click Update Record. 9. From the Security Record Updated Successfully, click Back. 15

Modifying the status of a provider Warning: deleting any part of an inactive provider will damage any records that are attached. 1. On Oscar s main menu, click admin. 2. On the Administrative Page under the Provider menu, click Search/Edit/Delete Provider Records. 3. On Search a Provider choose Search Criteria - Last Name or Provider No., and then check Active Only. 4. Type the providers Last Name or Provider Number in the search field. 5. Click Search. 6. In the Status text field, type a zero (0). 7. Click Update Record. 8. From Update a Provider Record Successfully, click Back. Reinstating a locked out provider Only a provider with administrator privileges can re- instate a locked out provider. 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Security menu, click Unlock Account. 3. On the Unlock page from the Role name dropdown menu, select the providers name and then click Unlock. Troubleshooting login issues with a Login Report The Login Report records the login details of all authorized (and unauthorized) providers. This report is handy when determining why a provider was unable to login to Oscar. 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Security menu, click Security Log Report. 3. On Log Admin Report from left to right: a. From the Provider dropdown menu, select a provider (or all) b. On the start pop- up calendar choose a start date c. On the end pop- up calendar choose an end date d. From the next dropdown menu on the right choose a report type e. Click on Go 4. Examine the columns for any irregularities. 16

Ø A comment of failed appearing more than 3 times consecutively in the Action column on the Log Admin Report is a clear indicator that this provider is locked out and may have forgotten their password. 5. On Log Admin Report, click Exit to finish or - Print and then Exit to print. Managing Provider Preferences A logged in user can modify user preferences. Commonly modified preferences are covered in this training. To set preferences for a practitioner, logout and then login with the target practitioners login credentials. Setting a provider signature A signature is how a providers name will display on official documentation. 1. On Oscar s main menu, click Pref. 2. On the Preference page, click Edit Your Signature. 3. Click Click here to create a new signature. Ø If a signature already exists, simply edit it. 4. In the Provider Signature text field, type a signature. 5. Click Submit. Setting a provider s clinic hours This preference determines an availability period for a provider. 1. On Oscar s main menu, click Pref. 2. On the Preference page a. Type your daily Start Hour (24 hour clock). b. Type your End Hour (24 hour clock). c. Type your average appointment Period (minutes) Changing a password Ø An appointment period is also called a time block or unit. 1. On Oscar s main menu, click Pref. 2. On the Preference page, click Change Your Password 3. On Change Your Password type your old Password and then type your new Password, type your new Password again to confirm. 4. On Change Your Password, click Update. 17

Building a Provider Schedule Doctors cannot book and manage appointments without first building a provider schedule. The provider schedule maintains appointment sessions, breaks and availability. Understanding time blocks Time blocks are important for managing how many patients a practitioner can examine in a day. Time blocks keep the pace in a clinic and ensure that all patients receive the same level of care. Before setting up a schedule for a practitioner it is important to determine the minimum standard of time they require for each patient. Often 15- minute time blocks are an acceptable average. After setting up a practitioner s daily schedule, each time block will be visible in Oscars main appointment page. When making appointments it is important to determine how many time blocks a patient will require. Two 15- minute time blocks equals a 30- minute appointment time. Setting clinic holidays and closures Determine all the dates that the clinic does not take appointments and enter them into a schedule. Diligence helps avoid embarrassing appointment mistakes. 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Schedule menu, click Schedule Setting 3. On Schedule Template Setting, click Holiday Setting. 4. Type a Holiday Name. 5. On the calendar, check off all days that apply to the holiday. 6. Click Save. Create custom template codes Template Codes are single character codes that indicate what each time block is reserved for. For instance, L indicates a time block for lunch break. 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Schedule menu, click Schedule Setting 3. On Schedule Template Setting, click Template Code Setting. 4. On Template Code Setting 18

a. Type Code L b. Type Description Lunch Break c. Type a Duration d. Choose a Color for the time block e. Click Save Creating a clinic schedule template Templates determine a common work schedule that can be shared with groups of providers or individuals. For instance: A walk- in template can be created to confine a group of doctor s schedules within a specific schedule parameter. A practitioner may have two schedule templates one for hospital rounds and another for clinical. The following task demonstrates the creation of a template for a clinic that is open from 9am to 5pm. 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Schedule menu, click Schedule Setting 3. On Schedule Template Setting select Public from the dropdown menu next to Template Setting. 4. On Schedule Template Setting, click Template Setting. 5. On Day Template Setting on the top right set the time block minutes from the dropdown menu. 6. On Day Template Setting next to the time block drop down, click Go. 7. Type a Template Name 8. Type a Summary 9. Type Template Code 1 in each of the blank slots starting at 9am through 5pm. Ø On Day Template Setting hover the mouse pointer over Template Code to view all currently available template codes. 10. Click Save Ø For larger complex clinics, it is helpful to draw relationship diagrams prior to creating schedule templates. 19

Editing a schedule template 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Schedule menu, click Schedule Setting 3. On Schedule Template Setting from the dropdown menu next to Template Setting, select Public. 4. On Schedule Template Setting, click Template Setting. 5. On Day Template Setting at the top right, from the dropdown menu, select a template to edit. 6. On Day Template Setting, next to the chosen template, click Edit. 7. Edit the template. 8. Click Save. Creating a new provider schedule 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Schedule menu, click Schedule Setting 3. On Schedule Template Setting from the Select a Provider dropdown, select a provider. 4. On Schedule Setting a. Type a start date for the provider and set the end date to a year later b. In the left column of the table click on the checkboxes next to the days of the week that the provider is available. c. In the right column of the table click on the schedule template to apply. Ø A visual of the selected template will appear in a column to the right. d. In the center column of the table click the arrows << to apply the chosen schedule template for each relevant day of the week. 5. On Schedule Setting, click Next. 6. Review the new schedule, and then click Next 7. On the final page, click either Do it Again or Finish. Creating appointment types Appointment types are a predetermined list of appointment types with an expected duration. For instance: a full yearly physical requires a 45- minute time block. 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Schedule menu, click Appointment Type List. 3. On Appointment Types type the: 20

a. Appointment name b. Duration c. Reason 4. On Appointment Types, click Save. 21

On Boarding Patients (Demographic) The tasks in this module outline the very basic steps to creating and maintaining a patient master record. Navigating a Patient s Master File The Patient s Master File interface is the main menu leading to all tasks for adding or modifying information related to the patient such as: lab requisitions electronic forms consultation letters prescriptions chart notes appointment history billing and billing history master record. The Patient s Master File interface can be broken down into a: task menu in the left most column heading that contains the patients name and appointment information search field for search another patient master record summary tool bar. Each item within these menus will be performed during related tasks throughout the remainder of this manual. Review a visual diagram of the Patient s Master File attached at the end of this manual (Appendix 2: Patient Master File Interface). Searching for patient master files Searching for a patient record prior to creating a new one should be made a common practice. Doing so saves time and eliminates the potential for duplicate records. 1. On Oscar s main menu, click Search. 2. On the By dropdown menu select a search parameter 3. In the Input field, type a search criteria Ø Searching by name requires a last name first format. I.E.: Joe Patient is searched for by Patient, Joe. 22

Ø Searching by BC Care Card number will not always return a result in situations where the patient was previously private or inter- provincial. 4. Click Search for active patients or click Inactive for inactive patients or click All for all inactive and active. Ø Always search for All (inactive and active) records; previously inactive patients can then be re- activated. 5. On the Search For Patient Records results table, in the left most column Demogp No., click on the number that corresponds to the desired patient. Ø Clicking on the column heading for each column of the results table sorts the results by each criterion incrementally. Creating a patient master file A patient master record contains all the vital demographic information for a patient. 1. On Oscar s main menu, click Search. 2. On Search/Add Patient Records - from left to right: a. On the By dropdown menu select a search parameter. b. Into the Input field, type a search criteria. c. Click Search. Ø Matching search results are not expected in this task. 3. On Search for Patient Records, near the bottom, click Create a New Demographic. 4. On Add a Demographic Record type or select data for the following required fields (left to right top to bottom): Ø Oscar does not deal well with punctuation and special characters in any of these fields. a. Type the patients Last Name. b. Type the patients First Name. c. From the Language dropdown menu select an official language. d. From the Title dropdown menu select a title for the patient. e. In the Address field, type the patients street address and apartment. f. In the City field, type a city for the patients street address. g. From the Province dropdown select the province for the patients address. h. Type the patients postal code in the Postal field. i. In the Phone (H) field, type the patients home phone number. 23

j. From the DOB (yyyymmmddd) label (left to right): i. In the yyyy field, type in the patients year of birth. ii. In the following dropdown menu select the month of birth for the patient. iii. In the next dropdown menu select the date of birth for the patient. k. From the Sex dropdown menu select the gender of the patient. l. In the Health Ins. # text field, type the patients Health Care Number. m. If the patient is inter- provincial: i. From the HC Type dropdown menu select the patients billing province. ii. Next to EFF Date and Renew Date type into the text fields the year/month/day of the effective date and renewal date for the patients health care if required. n. From the Doctor dropdown menu select the patients regular doctor. o. In the Referral Doctor text field, type the name of the doctor that referred this patient. Ø Referral Doctor can also be the patients regular family doctor. p. In the Referral Doctor # field, type the referral doctors CPSID. Ø Next to the Referral Doctor # is a Search link. Use this to search for a referral doctor. q. In the Alert text area, type any important details about the patient that should be viewed by other providers. r. In the Notes text area, type any important profile notes about the patient. 5. On Add a Demographic Record at the bottom, click Add Record. Ø Failing to create a patient master record prior to entering appointments will result in lengthy calls to an Oscar Support Service. Editing a patient master file 1. On Oscar s main menu, click Search. 2. On Search/Add Patient Records - from left to right: a. On the By dropdown menu select a search parameter. b. In the Input field, type a search criteria. 24

Ø Searching by name requires a last name first format. I.E.: Joe Patient is searched for by Patient, Joe. c. Click Search for active patients or click Inactive for inactive patients or click All for all inactive and active. Ø Always search for All (inactive and active) records; previously inactive patients can then be re- activated. d. Click Search. 3. On Search for Patient Records in the results table under the Demogp. No. column, click on the number that corresponds to the target patient. Ø The search parameters or criteria may be incorrect if there is no patient results in the results table, try the search again with new criteria. 4. On Patient s Master File in the Record table just above the Demographic Last Name, click Edit. Ø The word Edit to be clicked is very small and blue don t give up, it s there. 5. On Patient s Master File in the Patient Detail Info, modify any data as required. 6. On Patient s Master File at the very bottom, click Update Record. Ø There is an option to search for another patient record at the top of the Patient s Master File. Changing the status of a patient file When a patient no longer visits the clinic the Patient Master File status can be changed to inactive. Also, a duplicate Patient Master File can be changed to inactive to avoid confusion. In either case do not delete any part of a patient master file. 1. On Oscar s main menu, click Search. 2. On Search/Add Patient Records - from left to right: a. On the By dropdown menu, select a search parameter. b. In the Input field, type a search criteria c. Click Search for active patients or click Inactive for inactive patients or click All for all inactive and active. d. Click Search. 25

3. On Search for Patient Records in the results table under the Demogp. No. column, click on the number corresponding to the target patient. 4. On Patient s Master File in the Record table just above the Demographic Last Name, click Edit. 5. On Patient s Master File edit view near the bottom from the Patient Status dropdown menu, select inactive. 6. On Patient s Master File edit view at the bottom, click Update Record. Joining patient master files Patent master files can be joined together to represent a relationship. This feature is most useful in cases where children need to be linked with the mother, or a husband and wife. Ø All linked patients must have an active master file at the same clinic. 1. Complete the task: Searching for patient master files. 2. On Patient s Master File in the Record summary next to Other Contacts, click Add Relation. 3. On Add Relation in the Name text field, type the last name of a relative. 4. On Add Relation next to the Name text field, click Search. 5. If a single result is returned skip to step 7. 6. On Patient s Record on the Results table in the Demogrp. ID column, click an ID number. 7. On Add Relation inside the Relation group set: a. From the Relationship dropdown menu, select the relationship type. b. Checkmark if the relation is a Substitute Decision Maker. c. Checkmark if the relation is an Emergency Contact. d. In the Notes text area, type some notes. Ø The name of the patient you are linking with is displayed in the header of the Add Relation window. 8. On Add Relation inside the Relation field set, click Add Relationship. Ø The Patient s Master File will now display the relationship under Other Contacts in the Record summary. Unjoining patient master files 1. Complete the task: Searching for patient master files. 2. On Patient s Master File in the Record summary next to Other Contacts, click Add Relation. 3. On Add Relation next to the patient to be unlinked, click del. 26

Managing the Clinic Schedule The tasks throughout this module demonstrate how to manage Oscar s appointment scheduling system. Creating and editing schedule groups Schedule groups contain a group of providers that share a common task. In example: A Walk- In group can be created to contain all the schedules for practitioners who encounter only walk- in patients. Each group of schedules can be displayed in Oscar s main schedule view by selecting it from the Group dropdown menu in Oscar s calendar view menu. Creating a new group 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Group No menu, click Add a Group No Record. 3. On New Group in the Group No text field, type a group name (max 10 characters, no punctuation, no spaces). 4. On New Group under the Group No text field, click each checkbox on the right hand side of each provider name that will be in this group. 5. On New Group at the bottom click Save. Modifying a group 1. On Oscar s main menu, click Admin 2. On the Administrative Page under the Group No menu, click Search/Edit/Delete Group No Records. To remove providers from a group: a. On My Group, click each checkbox to the left of each group name and provider name to be removed. b. On My Group, click Delete. To add providers to a group: a. On My Group click New Group/Add a Member. b. On New Group in the Group No. text field, type the group name to be modified. c. On New Group on the left side of each provider to be added, click each checkbox. d. On New Group, click Save. 27

Navigating Schedule Views Oscar s schedule has several different views that ease future scheduling, viewing multiple schedules and viewing single schedules into the past and future. Refer to Appendix 1: Anatomy of an Oscar at the end of this manual to help with menu descriptions. Oscar s Main Menu (Item 1 from Appendix 1: Anatomy of an Oscar) contains schedule view options: Today: Click Today to change the main schedule view to the current date. Month: Click Month to change the main schedule view to the current month. Search: In the text field to the left of GO, type the last name of a provider and then click GO. This search will change the main schedule view to the schedule for the searched provider. The Calendar View Menu (Item 2 from Appendix 1: Anatomy of an Oscar) offers different options for navigating the clinic schedule: Current Date: Click on the red arrow on each side of the current date to change the main calendar view to the previous and next dates respectively. Calendar: Click on Calendar, on the calendar view click last month or next month to select a specific month and then click a day to select a specific day - the calendar main view will jump to the date selected. Current User: The name displayed next to Hello identifies the name of the currently logged in user (not the name of the schedule). Group: From the Group dropdown menu select a name or group name for schedule(s) to be viewed in the main display. Schedule View: Click the Schedule View to view only the providers who are on schedule for the current day. A blank schedule will appear greyed out. Case Load: Click Caseload to view and analyze a providers Case Load. The Provider Schedule View Menu (Item 3 from Appendix 1: Anatomy of an Oscar) contains view options for navigating a provider schedule: W: Click W to view the weekly schedule for the provider displayed in this menu. S: Click S to search for the next appointment block available for the provider displayed in this menu. O: Click the radio button to the immediate left of the provider name for an alternate schedule view known as the Flip View. Current Schedule Name: click on the provider name to isolate this provider schedule from others in the same group. 28

Managing Appointments Creating a new appointment Refer to diagram Appendix 2: Anatomy of an Oscar at the end of this manual for menu locations. 1. On the Provider Schedule View Menu, confirm the provider name for which the appointment is being booked with. 2. On the Calendar View Menu select a date for the appointment by navigating the Current Date or Calendar selectors. 3. On the Main Schedule View, click the Appointment Time Slot corresponding to the start time of the appointment. 4. On Make an Appointment: a. Confirm the provider name, Date and Start time of the appointment - adjust each if necessary. b. In the Duration text field, type the appointment duration - or leave at the default. c. In the Last Name text field, type the patient s last name. Ø For a more accurate search, place a comma after the patient s last name and then add any portion of the beginning of the patient s first name. d. Across from the Last Name field, click Search. i. If multiple results are returned: On Patient s Record in the results table from the ID column, click the relative patient id number. ii. If no results are returned: either adapt the search parameters or create a new patient record. e. At the bottom, verify if the retrieved patient details are correct. f. In the Reason text field, type a reason for the appointment. Ø Appointment reasons are helpful with determining the appointment duration. g. In the Notes text area, type any relevant notes. h. Click Add Appointment. 5. Confirm that the new appointment is in the correct time blocks within the main schedule view. 29

Searching for an available appointment The Oscar appointment search feature is useful for quickly locating the next available appointment block for a specific provider. 1. On the Provider Schedule View Menu (Item 3 from Appendix 1: Anatomy of an Oscar), click S. 2. On Search for Next Available Appointment: a. From the Provider dropdown menu confirm the correct provider is selected. b. From the Day of Week dropdown menu select a preferred day of week for the appointment. c. From the Time of Day dropdown menu select a preferred time of day. d. From the Appointment Type dropdown menu select the type of appointment desired. e. From the Number of Results dropdown menu select the number of appointment options to return. f. Click Search. g. On the search results table that appears below, click the desired appointment. 3. On Make an Appointment, complete the steps 4 through 5 from the task Creating a New Appointment. Modifying an appointment Appointments can be deleted, cancelled, moved, closed and notated as no show. The following tasks outline a brief instruction for each action. 1. On the Active Appointment in Oscar s Main Schedule View (Item 6 from Appendix 1: Anatomy of an Oscar), click the patient name. Editing an appointment Any part of the appointment details can be edited. a. On Edit an Appointment edit any detail as desired. b. On Edit an Appointment at the bottom, click Update Appt. Deleting an appointment When an appointment is deleted all record of the appointment is erased from Oscar EMR. a. On Edit an Appointment at the bottom, click Delete Appt. b. On the pop- up warning dialog, click OK. 30

Ø The appointment will be removed from the schedule view and this appointment will not appear in the patient appointment history. Canceling an appointment When an appointment is cancelled a note of the cancellation appears in the patient appointment history. New appointments will be allowed in this time block. a. On Edit an Appointment at the bottom, click Cancel Appt. Moving an appointment Ø The Active Appointment will now appear greyed out and a red X will display the cancelled status. Moving an appointment between practitioners and schedule dates is an easy task in Oscar EMR. a. On Edit an Appointment at the very bottom, click Cut. b. On the Main Schedule View navigate to the desired appointment date. c. On the Main Schedule View, click the Appointment Time Slot corresponding to the start time of the appointment. d. On Make an Appointment at the bottom right, click Paste. e. On Make an Appointment at the bottom left, click Add Appointment. No show appointment Ø To avoid losing this appointment it is important that no other action take place between the cut and paste procedure. No show appointment should always be noted for various administration reasons. The appointment will display a status of no show and a notation will be placed in the patient appointment history. a. On Edit an Appointment at the bottom, click No Show Ø The Active Appointment will now appear in a lilac color and a white circle displays a no show status. 31

Recurring appointment An appointment can be set to recur on a set schedule: f. On Edit an Appointment at the bottom, click R. g. On Repeat Booking input all relevant repeat booking parameters. h. On Repeat Booking at the top left, click Recurring Update. An appointment can also be set to recur on specific dates: a. On Edit an Appointment at the very bottom, click Copy. b. On the Main Schedule View navigate to the desired appointment date. c. On the Main Schedule View, click the Appointment Time Slot corresponding to the start time of the appointment. d. On Make an Appointment at the bottom right, click Paste. e. On Make an Appointment at the bottom left, click Add Appointment. f. Repeat steps b through e for additional appointment times. To view and edit a series of recurring appointments: a. On Edit an Appointment near the bottom, click Recurring Action. b. On Recurring Appointment use any tool to adjust the appointment series. Managing appointment status An icon located on the leftmost side of the Active Appointment menu indicates the appointment status. There are a variety of preset appointment status icons available by default in Oscar. Each icon represents an appointment workflow status. Clicking on the icon rotates the status icons. A meaning can be determined for each icon to indicate the status of an appointment workflow. An example appointment workflow: 1. Active appointment. 2. Patient has arrived. 3. Patient is in an examining room. 4. Patient is being examined. 5. Patient has left. 6. Appointment closed. 7. Appointment billed. 32

The methods to add new statuses and modify the appearance of a current status are beyond the scope of this training. Viewing patient appointment history 1. On the Active Appointment in Oscar s Main Schedule View, click M. 2. On Patient s Master File in the left column under the Appointment menu, click Appt. History. 3. Click Back to exit appointment history. Determining a Patients British Columbia Medical Services Plan (BC MSP) Eligibility It is possible to determine a real time status of a patient s eligibility with BC MSP. Frequently performing this task helps avoid obvious billing conflicts. 1. On the Active Appointment in Oscar s Main Schedule View (Item 6 from Appendix 1: Anatomy of an Oscar), click M 2. On Patient s Master File in the left column under the Billing menu, click Check Eligibility. Managing Patient Lab Results and Documents Patient lab results and documents come in two forms: electronic and scanned. The following task will demonstrate how to organize and file both forms of these lab results and documents. Interfacing with an electronic lab service An electronic lab service routes patient lab results from the lab to the clinic through a secure Internet connection. Electronic lab services use the common health informatics framework called HL7 to define the file format of electronic lab reports. Ø One HL7 file contains a batch of patient labs up to a limit of 101 labs per file. There are several different electronic lab services and each have a different method for retrieving labs. This training covers the task of manually uploading a HL7 lab file into Oscar EMR. 33