Horizon Physician Portal Training Guide 13.3.2 (November 2013)

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Horizon Physician Portal Training Guide 13.3.2 (November 2013) For assistance please call the Help Desk at 561-955-4037 Telephone support is available during normal business hours, to resolve access questions, establish, change or remove physician or staff users; and arrange training. After hours, technical support is available for resolving password issues and access problems only. Support is not provided on setting up or maintaining a connection to the Internet from your home or office. Your personal home computer is not supported. Any issues with your hardware or connectivity should be resolved by your equipment vendor and/or Internet Service Provider (ISP) prior to calling the hospital Help Desk.

Disclaimer The BRRH Physician Portal is a web portal designed to provide a single point of access to information, tools and services, specifically for the needs of physicians, clinical professionals and staff at Boca Raton Regional Hospital. BRRH Physician Portal is a private, secure network available only to authorized users. All users must register to receive a personal username and password, issued by Boca Raton Regional Hospital. You assume full responsibility for using the information on the portal, and you understand and agree that BRRH and its affiliates are not responsible or liable for any claim, loss, or damage resulting from its use by you or any user. While we try to keep the information on BRRH Physician Portal as accurate as possible, we disclaim any warranty concerning its accuracy, timeliness, and completeness, and any other warranty, express or implied, including warranties of merchantability or fitness for a particular purpose. BRRH also does not warrant that access to the portal will be error or virus-free. By choosing to use BRRH Physician Portal you acknowledge and agree to the terms of this Disclaimer. We reserve the right to modify these terms and policies at any time. Unless otherwise noted, all documents accessed from this portal are viewed as a precious resource of BRRH and are Copyright, Boca Raton Regional Hospital, all rights reserved. Use of any data or other materials accessed from the portal without the permission of BRRH may result in action being taken against offenders. What will be covered in this training guide: How to Sign In to the Portal from within the BRRH network Page 3 How to Sign Into the Portal from outside the BRRH network Page 5 Clinical Navigation (how to move from patient to patient Page 8 What Services are available throughout the Portal Page 11 How to view / print results Page 12 How to view images - PACS Page 14 How to view another physicians Census / Coverage Page 19 How to personalize your Census Page 21 Summary View Page 21 How to add a patient to your Census (Physician Only) Page 23 How to Change My Password Page 24 CPOE Place Inpatient Orders Page 26 Deficiency Work list - Signing Your Records Page 27 How to Change Your PIN Page 24 Admission History Page 29 Medication Reconciliation Process Page 30 How to adjust font size when printing results Page 31 How to Log Out from the Portal Page 32 Optimum Equipment Specifications Page 32

How to Sign into the Portal from within the BRRH network. From the BRRH Intranet Home Page select Physicians/ Physician Portal: You will be presented with the Portal login screen: Enter your Username and Password If you do not have a valid username and password, please call the help desk at 4235 for assistance. Password Tips can be found on page 24

Clinical view presented after login authentication: Physician Data Monitor View presented after authentication: You are now ready to view/print your patient s records:

How to Sign into the Portal from outside the BRRH network: From www.brrh.com How to access the Secure Gateway Select the key image from the top of the page or Open a browser and enter the following URL: https://portal.brch.com You will be presented to the login page: Enter your username and password: You will be prompted to install Juniper. You will need to reboot if Juniper was previously installed.

Select Physician Access If Citrix has not been installed you will be prompted to install Citrix.

Citrix will launch and you will be presented with those applications that you have permission to use. Select Physicians Portal: You will be presented with the Portal login screen: Enter your Username and Password

Physician view presented after authentication: You are now ready to view/print your patient s records: Clinical Navigation: To navigate from patient to patient through ought the Portal, click on the Clinical Navigation Button or the Clinical Navigation Drop-Down box. The Clinical Navigation Button allows you to proceed to the next patient on your Census in room order. You can move forward to the next patient or back to the previous patient. The Clinical Navigation Drop-Down box will display all your current Census patients in a drop-down box, where you can select any of your patients by name and room number.

Clinical Results Display: After selecting a patient from the Clinical Navigation Button or the Clinical Navigation Drop-Down box, the Result Viewer will populate with the current (30days) clinical results. If you wish to see results that are older than thirty days, enter the number of day s back you wish to view into the Days Back box and click Refresh or press Enter. To view an individual result, click on that item. If you wish to view multiple results, put a check in the check box at the beginning of the result table and select Show Selected Results. You may view ALL results for this patient by clicking Show All Results. Results can be sorted to your liking. If you click on the title Item from the results table, the results will be sorted alphabetically by Item Name. You can reverse the alpha sort by clicking on the triangle that will appear once you select a sort option. You may sort by RsltLvl (result Level), Collected Date, Item Name or Status. If you would like to view any transcribed medical records, they can be found by selecting the Transcription tab.

Result Tags: All results have a result level tag (Icon) associated with it. These tags are labels that signify; by color that the user has viewed the result and that the result value is within a specific range. Icon Meaning New result that you have not yet viewed (green icon) New result that you have viewed STAT or Abnormal result that you have not yet viewed (yellow icon) STAT or Abnormal result that you have viewed Panic-status result that you have not yet viewed (red icon) Panic-status result that you have viewed Portal Navigation: From the Navigation link tabs, you may link to specific patient data throughout the portal.

Tab Name Services Census- WPL View all patients currently assigned to you. You may also view all patients assigned to your group or those that you are covering. Deficiency Edit and sign your dictated documents at this location. Clin Doc Clinical documentation such as Vitals and I&O Admission History View documented admission assessment. HHS Allergies, Problems, Procedures and Immunizations Doc View Assessment data and Nurses Notes Meds Given Complete listing of all medications ordered for Inpatients. Page also contains links to drug search utilities with many features including patient handouts. ECG ECG strip and findings are presented Facesheet Complete guarantor and insurance coverage for your patients listed on the current Census page. Medical Records Complete listing of all electronic Medical Records for all Inpatients and Outpatients. All Medical Record information is not printable. Records are currently being scanned into the system at discharge. Med Recon Medication Reconciliation - Notification to ensure that all medications are appropriately and consciously continued, discontinued or modified at point of care Results Complete listing of current results for your patients listed on the Census page. You may search for a result by a selected department. You will also find an image link to radiology images at this location. Summary Pick from a 24, 48 or 72 hour time frame and then chose which results you would like to view and in what order. This page also includes the Report Builder tool that generates a current Progress Note template. Transcription Listing of transcribed reports, which include, H&P, Op Notes, Consult Notes, Critical Care Notes, ED Documentation, Discharge Summary, Endoscopy and Surgical Notes. Orders/CPOE Complete listing of current orders for your patients listed on the current Census page. This is also where you would place an order (CPOE) for any inpatient. Patient Locate Patient Search, searchable database of all BRRH patients results. The Station Census, which allows you, access to all current (In-House) patients. The BRRH Staff Directory, which includes current name, address, phone, fax and NPI numbers. This is also where you can change your coverage to put another physician s patient on your Census.

Printing Patient Results: Once any patient result is displayed, you can print that result by selecting the printer icon that is located to the far right on the module title bar. Select the printer icon and an additional printer friendly window will be presented. Select print from within the printer friendly new window and the result will be sent to the local printer. This printout will be formatted to fit on the page with the patients name and number of pages labeled clearly.

Viewing Results: Once you have selected your result, it is presented in the Result Viewer. You may print this result by clicking on the printer icon. From the Result Viewer you can return to your original listing of results for this patient by selecting the Results List link. If you would like to compare the last five test results for this test, click on the Check 5 Across Tests link. Check 5 Across Tests will display the last five (if available) results with each component listed by collection date and time. A graphic representation of each component is also presented.

Physician Portal CM Results Viewer with available PACS Images Link An icon will appear in the Links column for all studies with archived digital images. From the Portal CM Results Viewer select the procedure ordered to view the Report detail. You may also select the Image icon associated with that result to view the image. Physician Portal CM Results Viewer Report detail with available PACS Images Link Once the selected report is displayed you will see the View Image link presented for the image that is associated with that report. Click the View Image link to display the image.

The image will display in an alternate window. Click the Studies drop down to display additional studies for this patient. Click Return to exit from this study.

To launch a higher resolution viewer (HRSD) select the Launch Imaging Tools link HRSD will begin setup

Select Install Select Next

Once the install is complete you will be presented with the high resolution image that you selected.

Coverage: To view another physicians Census (WPL) If you would like to view the Census of another physician, you will need to select that physician from the Staff Directory and add yourself as Covering. The Physician Directory is located on the PT Locate tab. From the Staff Directory, enter the physician name, whose census you would like to view. Click Search. You will be presented with a listing of physicians with that name. Once the Staff Directory module has presented you with the physician who s Census you would like to access, check the box in the Cover column. If you want to cover for a group, search for the group name and select all the members of that group. When you return to your Census, you will note that the physician that you chose to cover for has now been added to your Census Type Drop-Down box. To view the covered physicians Census, select the covered physicians name and click the Refresh button. The covering option will remain in your Census Type Drop-Down box until you remove the check that you added on the Staff Directory.

As a physician user of the Horizon Physicians Portal, you have the ability to customize your view. You can move the portal content as well as personalize your census view. To personalize your census selection, click the EDIT button on the Working Patient List module bar. Select the display format you wish to keep as a system default when your census is displayed. You may choose to view your census by Group, Covering, All Groups and Covering or for any individual on your listing. Make your selection and click Save. Your census will now display as you have selected.

Personalize your Walk Order Report: To personalize your Walk Order Report or move any content on the Census page click the EDIT button on the Working Patient List module. Once you save your changes, your census will retain the look that you select..summary Viewer: The Summary Viewer is presented after selecting the Summary tab from the Portal Navigation Tool Bar. Results are displayed for any procedures selected for the time selected.

You can lock down your personal preferences by selecting the EDIT button of the Summary Viewer. Make your selections from the list provided. You can chose a time frame and which results you would like displayed for that time frame. You may also select which order those results display on the page. You should also note that the Report (CM Report) builder tool is also located on this page. Select the Progress Note link to build a Progress Note template for the patient that is selected.

To remove a patient from your Working Patient Listing: Physicians Only Click on the check box that precedes the patient that you wish to remove from your listing. Once you put a check mark in the box, you will notice that the Remove button is now operational. Click the Remove button and your listing will display but the patient that you selected is now gone. If the patient had been discharged, this is a permanent delete. If the patent is in a room, they can be found by searching through the Station Census that is located on the Patient Locate tab. Adding a patient to your Working Patient Listing: Physicians Only You can add a patient to your listing at any time. Simply locate your patient utilizing the Station Census search on the Patient Locate tab, and put a check in the box under the Add column for the patient you would like added. The patient will appear on your list from that point on, just like any other patient.

Site Controls: From the Site Controls drop down you can, Add Content, Change your Password or Edit Preferences. Change Password: If you click on the Change Password link from the Site Controls drop down, the Password box is displayed. Once you enter your current password you will be presented with a new screen where you can change your account information. Password Tips: Password must consist of only alphanumeric characters. Password must start with a letter. Minimum password length is three characters. Password may not be the same as your username. Passwords are case sensitive, so be sure to be aware of the caps lock when entering a new password. You will be required to change your password every six months. Please call the Help Desk at 4235 if you need assistance. Changing your PIN: To change your PIN on the Deficiency Worklist, select the EDIT button from the module.

You will be presented with the Personalize Deficiency Worklist Module options. Enter your current PIN, New PIN (twice) and select SAVE.

CPOE Placing Inpatient Orders From the Orders tab select the CPOE button. Note: the order will be placed for the patient selected. If the patient has more than one active encounter (account) you will be prompted to select the correct inpatient account. The Orders template will open in another window. Note: The patient name is displayed at the top of the order template. Place all orders and select DONE (F8) when complete.

Deficiency Worklist Signing Medical Records Electronically From the Deficiency worklist, select which documents you would like to sign by putting a check in the box associated with that document and select Process. If you would like to sign all the documents on your worklist select Process All. You will be prompted to enter your PIN.

After entering the PIN, the first document from the worklist will be presented. To sign the document, click the sigh document button. If the document consists of multiple pages, you will need to view each page before the sign document button will display a red box. Once the red box is present, you may sign the document. You can edit the document at any time prior to signing.

Admission History - View documented admission assessment. HHS Allergies, Problems, Procedures and Immunizations

Medication Reconciliation If reconciliation is needed an indicator will display on the WPL, select the patient name and then navigate to the Med Recon tab. Select the Reconcile Medications button to begin. Prior reconciliations may be accessed at this location. To begin the Admission or Discharge reconciliation, select the appropriate start button. You may view the Medication Reconciliation tutorial on Health Stream for further instructions.

How to adjust the font size of printed reports: Select View/ Test Size/ Size: From the browser toolbar. This will allow you to increase or decrease the font size presented and printed. Print result by clicking on the printer icon, which is located at the top/right corner of each result.

How to Log Out from the Portal: Clicking on the Log Out option will log you out of the Portal. This prevents others from accessing records using your sign on. As a further precaution, you will be automatically disconnected after 15 minutes of inactivity on the system. The Suspend option will inactivate your login, temporarily. To reactivate, enter your password. It is essential that when you are done that you click on Logout. This is a privacy issue mandated by both JCAHO and HIPAA. Optimum Equipment Specifications For Physician Offices Browser technology impacts user performance Older browsers may introduce many seconds of delay New browsers have better support for printing Required Microsoft Internet Explorer 7.0 and above