EMR TIP SHEET | AUGUST 2016
Using TELUS Wolf to Support
Patient’s Medical Home
Contents
Introduction .................................................................................................................................................. 3
Patient’s Medical Home ............................................................................................................................ 3
Foundation for Success - Commitment to Standardization in the EMR ................................................... 4
Help Files ................................................................................................................................................... 5
References ................................................................................................................................................ 6
Panel Identification ....................................................................................................................................... 7
Patient Panel Definition ............................................................................................................................ 7
Demographics ........................................................................................................................................... 7
Basic Demographic Information ........................................................................................................... 7
Verification ............................................................................................................................................ 8
Status .................................................................................................................................................... 8
Configuring Status ................................................................................................................................. 9
To Delete a Status ............................................................................................................................... 10
Searches – Getting Started ................................................................................................................. 11
Producing a Provider’s Panel List ........................................................................................................ 11
Initial Panel Clean-Up .......................................................................................................................... 16
Bulk/Batch Actions .............................................................................................................................. 18
Panel Maintenance ..................................................................................................................................... 20
Deceased Patients ................................................................................................................................... 21
Panel Management ..................................................................................................................................... 22
Approaches to Panel Management ........................................................................................................ 22
Opportunistic ...................................................................................................................................... 22
Outreach ............................................................................................................................................. 22
Panel Management: How to Get Started............................................................................................... 23
Preventive Screening Care .................................................................................................................. 24
Disease Management ......................................................................................................................... 24
Management of Complex Patients ..................................................................................................... 24
Panel Management Examples................................................................................................................. 25
Preventive Screening .......................................................................................................................... 25
1
Rule Exemptions: ................................................................................................................................ 44
Registries ............................................................................................................................................. 45
Disease Management ......................................................................................................................... 48
Tools for Panel Management .................................................................................................................. 48
Clinical Decision Support: Population-wide point-of-care reminders ............................................... 48
Individual Patient Alerts ...................................................................................................................... 48
Clinical documentation so that data may be searched....................................................................... 49
Scanned Documents ........................................................................................................................... 49
Manual Entry of Lab Data ................................................................................................................... 50
Measurement.......................................................................................................................................... 51
Verification Rate ................................................................................................................................. 51
Screening Rate Based on Completed Screens .................................................................................... 53
Disease Management Rate ................................................................................................................. 55
Advanced Features of Wolf..................................................................................................................... 56
Custom Templates .............................................................................................................................. 56
Flowsheets .......................................................................................................................................... 57
Appendix A: Lists of scanned document index words/keywords ........................................................... 58
Appendix B: High Value Tips .................................................................................................................. 61
Notes (in Patient Maintenance) .......................................................................................................... 61
Configuration Settings ........................................................................................................................ 61
Exam Templates .................................................................................................................................. 64
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Introduction
Patient’s Medical Home
When an EMR is used in a meaningful way within the Patient’s Medical Home (PHM) model it supports
effective patient panel identification, panel maintenance, panel management and will enable proactive
panel-based care for patients in a practice.
Meaningful use of the EMR will enable ‘Panel & Continuity’, knowing which patients are active with each
provider and using this information for scheduling purposes and to monitor supply, demand and
continuity with the provider. This work is foundational for success, and must be discussed with the entire
practice, arriving at agreed upon policies and procedures on what, why and how data is to be captured
and maintained with the EMR.
‘Organized Evidence Based Care’ for preventive screening is a logical place to start to learn how to use the
EMR for panel management, or in other words, proactive panel-based care.
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Foundation for Success Standardization in the EMR
Commitment
to
Successful standardization of data entry for improvement or change, apart from leveraging the inherent
functionality of the EMR, relies heavily on three “people and process” principles in conjunction with the
EMR functionality for adoption and use.
These are:
1. Team

Includes having ‘engaged leadership’ and inclusive team representation within each clinic or
organization; A clinic champion for EMR standardization can be named

EMR improvements or changes do not happen in isolation, and require commitment of time and
resources to happen

Combining EMR improvement with enhanced use of team, process improvement and practice
facilitation is the ideal strategy in working toward adoption of the PMH

Leverage PCN supports where they exist (i.e. Improvement Facilitators, Panel Coordinators, etc.)
2. Data Quality

Data Standardization – for the main areas of data input, the entire clinic team should discuss and
agree upon:
o
use of fields in a standardized way, create structured exam forms or templates for the
consistent capture of patient information
o
utilizing standardized text or macros (auto-replace text) whenever possible instead of
free text
o
develop verification processes to ensure over time that data recording is reliable (e.g., BP
is always in the BP field and not in a text box in a SOAP note)
o
processes to record patient problems with the appropriate ICD9 identifier (highly
recommended)
o
where appropriate, to more clearly identify who documented the information in the
chart, it is recommended to use the individual initials in areas outside of chart notes (e.g.,
in demographic notes or while providing a reason for a bulk/batch change)

Develop and provide staff education with associated job aids for consistent patient data chart
entry (e.g., attaching keywords to documents to patient charts)

It is advised that one person or a small group provide direction for patient data entry to ensure
high quality in the clinic and minimize data inconsistency. Creating ‘Good in, Good out’ processes
at the practice

Documentation of Standard Operating Procedures (Policies, Procedures and Processes) assists a
clinic team in having a common understanding of workflow; these should be reviewed
periodically

Communicate with the practice team the linkage between data entry and the ability for a pointof-care reminder to function and inform reporting
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3. Incremental Change

A key recommendation is to take baby steps in EMR changes, especially when it concerns
practice-wide point-of-care reminders. These can be managed to make the changes small and
sustainable for the practice team

Use the simple but effective ‘Model for Improvement’ method including applying plan-do-studyact (PDSA) cycles to identify and test small incremental changes toward the desired and clearly
identified improvement goal

When a new point-of-care reminder is put in place an associated, documented ‘people process’
needs to be developed and implemented; thus making the change effective and sustainable, by
embedding it into the work process and clinic culture
Help Files
Along with the EMR tip sheet and videos made available on the TOP website, the embedded EMR Help
Files from TELUS can be a great untapped resource with detailed instructions on how to optimize EMR
functionality.
Help files and videos are searchable within the Wolf help files. Click Search and type the words to search
for in the window.
Telus Wolf Recommended help files will be referred to throughout this tip document as these are
available to all users.
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Additional learning opportunities exist with the Telus Health Wolf EMR Community Portal:
All Wolf users have access to the Community Portal from the home screen.
References
Patient’s Medical Home
http://www.topalbertadoctors.org/change-concepts/introduction/patientsmedicalhomeinalberta
Patient’s Medical Home Implementation Field Kit
http://www.topalbertadoctors.org/patients-medical-home-implementation-field-kit/
Patient’s Medical Home Assessments:
Readiness
http://www.topalbertadoctors.org/file/pmh-assessment-for-practices--readiness.pdf
Phase 1
http://www.topalbertadoctors.org/file/pmh-assessment-for-practices--phase-1.pdf
Phase 2
http://www.topalbertadoctors.org/file/pmh-assessment-for-practices--phase-2.pdf
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Panel Identification
Patient Panel Definition
A patient panel, or roster, lists the unique patients that have established relationships with a provider.
There is an implicit agreement that the identified physician will provide primary care services. Relational
continuity, or an ongoing relationship between a physician and a patient, is a key objective of establishing
a patient identification process.
Demographics
Basic Demographic Information
In Patient Maintenance, the demographic area of the patient chart, the basic information that is needed
for patient panel identification is:

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
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Full Name
Date of Birth
Gender
Complete address
Phone number(s)
Primary provider
Patient status (Active or Inactive)
o Status Date
o Verification date
Alberta Patient Healthcare Number (PHN)
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Verification
Wolf has a designated field for patient demographic data verification. Marking this field/box indicates
that the address, phone, patient status and provider attachment are up to date. The field also applies a
date stamp so that all know when it was last done.
The verification rate may be measured using Practice Search. Please see the Measurement section.
Status
In Wolf, the patient status is entered in Patient Maintenance on the Patient Status tab:
Patient Status is a searchable field in the EMR so it is important for panel identification.
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Configuring Status
In Wolf a system administrator can customize patient statuses for the practice in addition to what is
available in the EMR at ‘Go Live’. This will allow the practice to narrow down various types of active and
inactive patients in patient lists, reports or for setting up Practice Search Rules.
From the Home screen, choose Configuration > View > Patient Data Codes > Patient Status
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1) In the Patient Status Maintenance screen, complete the Description, Status Code (an in-clinic code
you give to the status) and the sort order, which organizes the order they appear in the drop
down menu. The Location code is optional and can be left blank.
2) Click the “Inactive” box if the status is to NOT be included for the physician’s active patient panel.
3) Save (by clicking the floppy disk icon).
4) If creating another status click on the New icon (piece of paper icon), and begin again.
5) Click Exit when done.
To Delete a Status
1) Click on the Status Code
2) From the top menu in Patient Status Maintenance choose File > Delete.
3) You will be asked to confirm
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Status
Active
Inactive
Examples of Patient Status Used in Primary Care
Status Name
Additional Information
Office Patient
Active office patient attached to a provider in the practice
Specialty Service
This patient may be active in the practice but only for a given service (e.g.,
vasectomy, aesthetic, maternity care, aviation medical, circumcision, IUD).
Some clinics give a status to each type of specialty service.
Temporary
Applied to a patient seeking walk-in care. These patients are not
considered part of the provider’s panel.
New
When a practice is still accepting new patients, a patient may not be
confirmed as an office patient until after a first or second appointment.
Orphaned/unassigned
When a provider leaves a practice resulting in an unassigned panel, these
patients may be identified.
Emergency Department
Mainly in rural centres, where a patient record exists for a visit that
occurred in ER of a non-clinic patient.
Long term care
For a group of patients seen in a long term care site but not the practice.
Lapsed or Dormant
Some clinics prefer to use this term for patients that are inactive, with no
clinic visit in a period of time (e.g., 3 years). They will be given this term
during panel clean up or maintenance.
Inactive
Includes formerly active patients with no clinic visits in a period of time
defined by the practice, (e.g., 3 years.)
Deceased
Patient is deceased.
Non-clinic patient / Not
When a patient chart is created for lab work received at the practice or for
Our Patient
a patient never seen at the practice (may apply to a new patient that
made an appointment but never visited the practice).
Duplicate or Archive
When a patient has accidentally been registered more than once and the
EMR does not have the ability to merge duplicate records the archived
record has this unique status.
Searches – Getting Started
When learning to create searches the following tips will assist in obtaining accurate data:
 Be informed on how data is recorded at the clinic; this will provide direction on which fields to search
 Build the search one parameter at a time
 Validate, as each line of the search is created, that the results are correct before adding another
parameter to the search
 Search for the positive first then search for the negative
o E.g., if you are searching for female patients 50 – 74 y that have not had a mammogram in
the past 2 years, first identify all patients that have HAD a mammogram in the past 2 years.
Once you have validated that your search criteria are correct it is easy to search for patients
that have NOT had a mammogram.
 Verify that your results are correct by checking the data in 3 -5 charts on the list
Producing a Provider’s Panel List
During the panel identification process the first step is to produce a list of all active patients attached to a
provider using the report/search functionality of the clinic EMR. Last Visit Date may assist with
determination of which patients are active:
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o
Patients with a visit in clinic during an agreed-upon, predetermined period (e.g., last 3
years)
These lists usually create awareness for initial panel clean up. Verification of the data produced on the
lists with the primary provider and team will help to determine validity of the information. Further panel
clean-up is assisted by additional searches in the EMR.
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Producing a Physician Patient List in Wolf:
These initial searches inform your initial panel information processes. From the Home screen, choose
Practice Search
Once Practice Search opens:
1. Choose Primary MD under Demographics.
2. Click the box beside “Search All Patients” in the upper right.
3. Click the third icon from the left to show search results as a Patient List.
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When a list is produced it looks like this:
The columns may be sorted by the headers by clicking on the header.
Sort by Last Visit Date:
Sort by Age:
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TIP: Wolf EMR will produce the list with Practice Search but
also offers exporting the list as a csv file for further sorting
and analysis in Microsoft Excel or another spreadsheet. To do
this, select File > Export All to CSV. Basic spreadsheet training
is recommended and be mindful of privacy requirements;
handle and dispose of that data appropriately.
Using the Demographic Viewer
In Wolf, instead of producing a list of patients, it is possible to produce a pie chart of results. The
advantage of this is that the results are generated much quicker and there are ways in the menu to sort
by age, gender and smoking habits. If the desire is to simply get a number, this is the fastest way to
achieve those results.
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Initial Panel Clean-Up

Searches/reports that assist initial panel clean up include producing a list of active patients
attached to a provider, with the additional search parameters of:
o
Last visit date (and no future appointments)
This search produces a list of patients assigned to Dr. Adams WITH a visit in the last 3
years.
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This search produces a list of patients attached to Dr. Adams with NO visits in the last 3
years and NO future appointments booked.
o

Age: Sorting the list of active patients by age is valuable. In viewing the list of active
patients over the age of 90 years, a provider is usually able to indicate if there are
patients on the list who should be marked as deceased
No visits to the practice (and no future appointments) – producing a list of patients that are
attached to a provider will identify patients that registered but may have never shown up to the
practice. This search may also identify registrations of patients where lab results were received to
the practice but the patients were never seen at this practice. Another scenario where this
applies includes where a physician has imported charts to the practice from another practice.
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
Appointment Type/Reason – If the practice uses the appointment type or reason when
scheduling visits, searching by this information will allow you to exclude or target patients that
are not family practice panel patients such as ‘aviation medical’ or ‘Botox injection’. See Wolf
Help files “Appointment Reason Maintenance” to set up apt types.

Billing code - If the clinic offers specialty services to patients that are not members of the
physician’s family practice, they may be identifiable by billing code from the Schedule of Medical
Benefits

o
Ask the providers if there are any billing codes that they routinely use for patients that
are not members of their family practice panel
o
Procedure codes –
E.g., searching by procedures offered at the practice, but all the patients may not
belong to the practice, such as vasectomy (75.64)

Long term care patients are billed with an 03.03E billing code
Address or postal code
o


Sorting of active patients by the address or postal code searches can be valuable in
identifying groups that may not be part of the family practice panel due to their place of
residence; temporary workers to an area may be identified this way
Last Name is Test – each clinic has test patients that were created for training or practice
purposes, for reporting and analysis they should not be included in the family practice panels.
These will need to be found in the patient search window from the Wolf Appointment Scheduler.
(first, be sure there are no real practice patients with the surname Test)
IMPORTANT: The primary provider and/or the practice team need
to review the data from reports to ensure that the correct
information is being pulled into them. Due to unique protocol at a
practice, fields may be used in a specific way and this may impact
the accuracy of reports.
Bulk/Batch Actions
Once a list is produced and sorted, Wolf is capable of applying a bulk change to the entire list or a group
within the list. Making bulk changes makes the process of initial clean-up and ongoing panel maintenance
faster and easier.
TIP: Carefully verify data with the primary
provider and/or care team before making a bulk
change.
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Deactivation is a two-step process:
1. Deactivate
1) Produce a verified list of patients that the clinic wishes to make inactive.
2) Choose Selection > Select All or click the box beside the patient names that you wish to
inactivate.
3) Choose Selection > Deactivate Selected.
2. Change Status to Inactive
4) Choose Selection > Update Patient Status
5) The Change Patient Status for Selected Patients window
appears.
6) Change status to “Inactive Patient”
7) In the Reason box write the person’s initials doing the
inactivating and a reason. Additional notes may be
added in the box below.
8) Select the current date at the Start Date. Click OK
TIP: Making a chart Inactive does not delete the
chart. A chart may be made Active and a patient
re-introduced to a provider’s panel.
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Panel Maintenance
Once an initial clean-up is complete there are several processes that support maintaining a clean patient
panel list for each provider. Those processes include:
1. Ongoing phone/address data, physician attachment and status verification at patient check in.
2. Developing and monitoring a process for all staff that works the front desk with expectations for data
verification is required.


This process can be checked using the EMR reporting. Run a search to produce a list of patients
with visits in a given period of time and determine what percentage of patients was verified
during that time frame (See Measurement Page 50)
Standard operating procedures should be in place for front desk staff for:
o Patients no longer part of the clinic
o Patients not seen in the clinic (e.g., records created for patients where lab work was
received or seen at another facility like the local hospital)
o Patients seen at your clinic but not your family practice patients (e.g., walk-in or
temporary patients)
o Patients scheduled for a “meet and greet” appointment
3. Conducting searches at regular intervals and applying bulk actions to patients that are no longer
active at the practice. The regularity of the intervals varies by practice. It may be monthly for the first
year and then every six months thereafter. Reports that assist identifying these patients include
searches by:
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Last visit date (and no future appointments)
Age
No visits to the practice (and no future appointments)
Appointment Type/Reason
Billing code
Address or postal code
Last Name is Test (first, be sure there are no actual practice patients with the surname Test)
4. Patient outreach. Some practices identify active patients with no visits in the past 3 years (and no
future appointments), prioritizing those overdue for preventive screening care, then reaching out
proactively to determine if they are still members of the practice. The outcomes of the outreach
involve updating the patient demographics, physician attachment and offers of preventive screening
care.
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Deceased Patients
When the need occurs, marking patient records as deceased supports maintaining clean patient panels.
In Wolf, change the patient status to deceased. The start date of the status should be the date the patient
is deceased. Add notes including the initials of the person making this change in the record.
Once a patient is marked as deceased, to view their information in Patient Search, select the Include
Inactive check box.
Patients with a deceased status are no longer active and will be excluded in Practice Search when the
“Not Deceased” box is checked.
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Panel Management
Panel management, also known as population management is a proactive approach to health care.
Population means the panel of patients associated with a provider or care team. Population-based care
(or panel-based care) means that the practice team is concerned with the health of the entire active
population of attached patients at the practice, not just those who come in for visits.1
The Patient’s Medical Home implementation element of ‘Organized Evidence Base Care’ involves
embedding evidence-based guidelines into daily clinical practice where each encounter is designed to
meet the patient’s preventive and chronic illness needs. Setting up population-wide point-of-care
reminders supports these planned interactions and EMR functionality supports appropriate follow-up
care.
Approaches to Panel Management
Opportunistic
When approaching panel management opportunistically, it means catching a patient while they are in the
practice or on the phone with a team member, to offer care.
For example, a 52 year old female is in the practice for an appointment to inquire about the
vaccine for shingles. While in the office her blood pressure is taken and she is offered requisitions
for a FIT test, plasma lipid profile, fasting glucose and mammogram because they are all overdue.
Methods to identify patients that are overdue for clinical services may involve:
 Setting up population wide Practice Search Rules that alert a team member that a patient is due
for a clinical service
 Creating a Follow-up for the individual patient to proactively set up for the next intervention
 A team member that combs through the charts of patients meeting certain criteria who have an
appointment to identify clinical services that are due (e.g., screening) and alerting the
appropriate team member to offer care
Outreach
An outreach method to panel management involves identifying active, paneled patients overdue for
clinical services that do not have appointments and ‘reaching out’ to offer care. This process involves
using the Practice Search in the EMR to produce lists of patients.
For example, a 58 year old male was last in the clinic 2.5 years ago for a knee injury. The panel
care coordinator (PCC) at the practice has run a report that shows this patient is overdue for a
plasma lipid profile, a FIT test and a fasting glucose. The PCC phones the patient and verifies that
he is still a patient in the practice attached to his paneled physician. * As per clinic protocol, the
PCC makes an offer that the patient can come by the clinic and just pick up the lab requisition to
get the overdue screening done and the clinic will follow-up if/as necessary. The patient agrees.
1
Module 20. Facilitating Panel Management. May 2013. Agency for Healthcare Research and Quality, Rockville, MD.
http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod20.html
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*Note: such protocols vary from practice to practice. It is an important process that must have
provider agreement before implementation.
TIP: It is recommended that a practice initiating outreach begin with patients
that have been verified as attached, active patients. This will prevent the
experience of contacting patients that are deceased or no longer active at the
practice.
Panel Management: How to Get Started
Once patient panel identification and maintenance processes are in place, it is recommended to begin
proactive panel-base care with the following approach:
Panel Identification & Maintenance
Panel Lists
Patient Verification
Preventive Screening Care
Foundational Learning
Simple to Complex
Point-of-Care
Reminders
Reporting
Disease Management
Disease Registries
Proactive Panel-based
Care
More Complex Pointof-Care Reminders
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Complex Patients
Automated processes
to support uncommon
care requirements
With ICD-9 codes in
place identify complex
patients for systematic
care
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Preventive Screening Care
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Preventive screening care involves a smaller number of data elements than disease
management
There is benefit to starting with some clean sources of data like electronic lab feeds
Clinic team will learn the importance of and begin standardization of naming protocols
for scanned documents (e.g., mammograms and colonoscopy reports)
Patterns will become apparent in their data entry and corrections can be made to
previously entered data and new incoming data for future meaningful use of EMR
Clinic team will start standard operating procedures that enable proactive panel-based
care
The searches and population-wide point of care reminders start simple and can build to
the more complex
Clinic team can build on:
 the number of screening maneuvers they are addressing
and/or
 the population of patients at the practice that point-of-care reminders are set for
(e.g., gender and age)
Provides a foundational experience for process improvement
Disease Management


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

Clinic team can take lessons learned from less complex preventive screening care
processes that can then be applied to disease management
Involves more complex searches with more data elements than screening
A dependency exists on reliable registries of patients with a given disease
Providers will learn the importance of consistent coding in the Problem List of the EMR
Clinic team will build on the benefits of standardized data entry
Building of more complex point-of-care reminders with increased reliability of planned
prioritized care
Management of Complex Patients

With a solid foundation in preventive screening care and disease management, patients
with complexities and multiple, co-existing conditions will have visits that address many
predictable health issues by using available resources more efficiently to reliably meet
patient’s most important needs
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Panel Management Examples
Preventive Screening
As per the Alberta Screening and Prevention (ASaP) Program
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Preventive Screening Searches:
Use the EMR Practice Search capabilities to identify patients due for preventive screening care:
Vitals:
Practice Search will be looking at vitals entered in the Vitals entry area or from Vitals within an Exam of a
SOAP note:
From F6 Vitals Entry
From SOAP Note
Exam Vitals
Entry
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1. Identify patients 18 + with no height recorded in Vitals on the chart
2. Identify patients 18+ with no weight recorded in Vitals on the chart in the past 3 years
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3. Identify patients 18 + without a Blood Pressure recorded in the Vitals area in the last year.
4. Identify patients 18+ that have not had a tobacco use assessment in the past year.
Identifying whether patients have not had a tobacco use assessment will depend on where tobacco
use is documented. It is recommended to document tobacco use in the Personal Risks area of the
chart. This is accessible from the SMART menu (right mouse menu) or in the Personal Hx tab in the
Harmful Substances area. This is the only place to document tobacco use that will impact the SMART
banner.
When in the smoking area, if the drop-down menu is not changed, the box must be checked that the
smoking status has been verified.
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In Practice Search, to identify patients 18+ that have not had their tobacco status verified in the past
year, use the following search.
5. Identifying patients due for exercise assessment.
In Wolf EMR there is not a pre-built field for exercise assessment. To document (as per the ASaP
recommendations to assess patients that are above or below the recommendation of 30 minutes 5
days per week, or 20 to 25 minutes every day; major muscle groups and bone strengthening activity
>2 days per week) another field must be used.
One option is to use an exam template with a designated field for exercise assessment. This can be
created using the Custom Exam Template Wizard, or available from TOP.
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Exercise recorded in a custom exam template:
Custom exam field searched in Practice Search to identify patients without the exercise field used
in the last year:
Other approaches to recording and measuring exercise:
 Manual lab results (may require assistance for set-up)
 Create an Investigation Type called screening in configuration and an
Investigation called Exercise Assessment
 This will allow any team member to record that an exercise assessment was
completed and measured in Practice Search
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
Auto-text replace can be used to create a consistent term for exercise assessment and
thus it is searchable in practice search.
6. Identify females 25-69 y that have not had a Pap test in the past 3 years
Before beginning this search it is necessary to identify how the pap is coded by the regional lab
service and received in the EMR. In Calgary lab zone it is coded as “Gyn Cytology”. In the Edmonton
zone it is coded as “anatomical pathology” so there is a special trick to finding lab results that only
contain gynecological cytology results.
Another point of awareness is the use of the Preventive Care Procedures area of Wolf on the
Investigations tab of the Medical Summary. This field is also searchable independent of the lab
results. If a provider documents all interpretations in the Preventive Care Procedures area, it is
searchable from there as well. In Practice Search it may be searched under History > PAPS
Exclusion: Female patients that have had a surgery documented as a “total hysterectomy” for benign
disease may be excluded from a preventive care search for a pap, however, most practices have not
had reliable and consistent documentations of surgery in the patient history tab so it may be safer to
include all patients and exempt patients from Practice Search Rules individually. This decision in
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Practice Search may be made by practice or by provider. Patients with a subtotal hysterectomy and
retained cervix continue with screening as per cervical cancer guidelines.
Anatomical pathology
In Calgary lab zone this area should read: “Gyn Cytology”
In the DKML/Edmonton zone this area should read: “anatomical pathology”, Where Text “Has Phrase
cervical”.
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7. Identify females 50 – 74 y that have not had a mammogram in the past 2 years (a mammogram
may be a scanned document and/or an electronic result, depending on the region).
This search is looking for females 50 – 74 y attached to Dr. Adams that have not had a document with
the keyword “mammogram” nor a Preventive Care Procedure documented in the past 2 years.
If a clinic is receiving mammogram results electronically as an investigation, as in the Edmonton Zone,
mammograms would need to be searched in Lab Results.
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8. Identify females 50 – 74 y that have not had a lipid profile in the past 5 years.
A lipid profile includes total cholesterol, HDL, LDL and triglycerides. Since HDL, total cholesterol
and triglycerides may be ordered separately, an LDL result indicates a completed lipid profile.
This search looks for a patient that has not had anLDL cholesterol that is reported in a lipid
profile.
Option: Patients already identified at risk of cardiovascular disease and are taking a Statin (HMG CoA
Reductase Inhibitor) are no longer being screened for lipids (because they are already identified at being
at risk) and lipid screening is no longer required in this population, as per the Prevention and
Management of CVC Risk in Primary Care Clinical Practice Guideline.
If the active medication list in the EMR is reliable, to Exclude Matches of patient taking this medication,
this may be added in practice Search:
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9. Identify patients 40 + that have not had a fasting glucose OR a HbA1c test in the last 5 years
Option: If the Problem List is reliable and coded consistently, patients with the diagnosis and problem
entry of Diabetes may be excluded from this search using History – Problem (ICD9) or History – Problem
(Specific) and “Exclude Matches”. Another consideration is that if the problem list is unreliable, patients
with a diagnosis of diabetes should be having a test for HbA1c or fasting glucose more often than once
every 5 years anyway and would not appear in the search results.
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10. Identify patients 50 – 74 y that have not had a fecal immunochemical test in the past 2 years OR a
flex sigmoidoscopy in the past 5 years OR a colonoscopy in the last 10 years (where a FIT test is a
lab result and a flex sig or colonoscopy can usually be identified by a scanned report).
This search relies on consistent document keywords for colonoscopy and sigmoidoscopy reports.
EMR TIP SHEET | AUGUST 2016
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CV Risk Calculation
This is a highly valuable tool to assess risk in patients with no previous cardiovascular disease (e.g., NOT
taking a ‘statin’ class of medication) as per the Prevention and Management of CVC Risk in Primary Care
Clinical Practice Guideline.
 Conduct on males 40 – 74 or females 50 – 74 every 5 years
 Requires other data held in the EMR: gender, tobacco use, BP, non-fasting lipid data and
diabetes diagnosis (for some CV Risk calculators)
 May use an internal EMR CV Risk Calculator or an external calculator such as:
http://chd.bestsciencemedicine.com/calc2.html#basic
o Dependency on where the provider records the result or if it is auto created from the
internal calculator in the EMR
 The preventive care screening search is to identify:
o Males 40 – 74 y, not taking a ‘statin’, that have not had a CV Risk calculation in the past 5
years
o Females 50 – 74 y, not taking a ‘statin’, that have not had a CV risk calculation in the past
5 years
To conduct a CV Risk Calculation using the Wolf access the Cardiac Risk Worksheet:
 Using the SMART Menu (Right Mouse Menu)
 From a SOAP note
See the Wolf Help File: Cardiac Risk Worksheet
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While in the Cardiac Risk Worksheet, if the print icon is used, a document is created with the document
keyword “Cardiovascular Risk Profile” that is available in the Document Tab of the patient’s Medical
Summary.
To use Practice Search to identify male patients 40 – 74 y, that have NOT had a cardiovascular risk
calculation/cardiac risk worksheet in the past 5 years, use the following search:
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To exclude patients currently taking a statin class of medication (HMG-CoA reductace inhibitor) from the
search for patients that have not had a cardiovascular risk calculation:
Use a separate search for female patients 50-74y,
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Preventive Screening Searches to Rules
Wolf EMR has an innovative tool called Practice Search Rules or commonly called Rules. These rules are
used to manage a set of patients defined in a practice search and automatically trigger reminders and
notifications for physicians and front staff if a patient matches any rule criteria. This tool enables
proactive panel-based care.
Important help files in Wolf EMR to review regarding Rules:

Practice Search Rules

Wolf EMR Pre-Defined Practice Search Rules

Practice Search Rule Exemptions
Tips in using Practice Search Rules:

A Rule is built from a validated search

The Rule will “turn off” when the criteria to meet the rule has been completed. So a Rule that
identifies patients due for diabetes screening will turn off when the HbA1c or Fasting glucose lab
result is received into the patient chart. This will allow the practice team to remind the patient to
complete a recommended maneuver until it is completed

Rule Matches View (accessible from the Workdesk) has some useful filters that allow a practice
team to conduct proactive panel-based care and identify a list of patients with appointments
today that have active Rules

Managing exemptions or deferrals in Rules allows for customization to individual patient care

o
A rule can be deferred for a day (does not accept the offer of a pap today) or a complete
exemption (a patient with a complete bilateral mastectomy
o
Rules are available in the SMART Menu (right mouse menu) to see all the managed rules
for that patient
o
Rule exemptions can be actioned from the Rule Matches View as well as from the Patient
Record
Use the pre-defined Rules to learn how to build rules then customize your own searches to build
Rules
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
Start incrementally and have a clinic team process ready for each active rule

A rule can be created, made inactive and turned on when a practitioner or practice is ready

Rules can be built for one provider to start and additional physician panels added incrementally

If Rules are being ignored it is recommended to make them not Active and incrementally make
the Rules active in a sustainable way in the practice
Example Using Practice Search in Wolf EMR for Preventative Screening in the General Adult Population.
Height - Identify active (not deceased patients) age 18+ with no height in their record.
Rule: No Height on record
Save Current
Search
Show Search
Results as a
Patient List
200
Show the Search Results as a Patient List to validate. This list can be printed or saved as a csv file to open
in Excel or Open Office Calc.
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To save this as a Rule, click on the Save Current Search icon, then, the following screen appears:
To Save the Search as
a Rule:
1) Write some
informative text
to display when
patients match
the rule
2) Assign a priority
(default is 5)
3) Click “Active”
4) “Save as New”
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Rule Exemptions:
Important points from the Wolf Help file on Practice Search Rule Exemptions:

Enter an End Date, or choose from the quick-pick intervals when exempting patients. No end date
means a permanent exemption (though, it may be edited)

When there are patients exempt from a Rule it will indicate so in the Practice Search results.
To view the list of exempted patients, click View > List Exempted Patients.
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Registries
A registry identifying patients with a coded (disease) condition is the first step in preparing for panel
management of patients with a given condition. The formation of coding of patients with a condition is
called a ‘patient registry’. Ideally, all patients with a condition will have the condition noted in their
‘Problem List’ in a consistent way. For example, Diabetes is always called ‘Diabetes Mellitus’ and will likely
have the ‘250’ ICD-9 code attached to it. It is important that an entire practice agree on terms for the
conditions to create registries. In this example Diabetes is not named with other inconsistent terms such
as ‘Diabetes’, ‘DMII’, ‘DM2’, ‘Diabetes M’, etc.
TIP: Free typing in the problem list is NOT recommended. Physicians should
use the drop down list when coding problems. In some cases a “clean-up” of
the list may be needed to enable consistent coding moving forward.
While the Service Codes used in claims or billing is a very useful search to inform the practice when
forming registries, it is not always accurate enough to be used when creating point of care reminders. An
accurate problem list should be the trigger for the point of care reminders.
Important Wolf Help Files:



Problem List
Problem Index
Quick Entry – Problems tab
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Problem List Tips:




Avoid free typing and adding descriptions to the master list problem in your clinic database;
search for the coded problems
Have the providers agree on a limited list of problems that you may wish to search or create
Rules for (up to 10 - 15 to start)
Agree on consistent naming for those problems
Place a list of those problems and codes at each workstation (example below)
Family Clinic Problem List
Hypertension 401
Diabetes Mellitus 250



Obesity
278
Tobacco 305.1
COPD 496
Asthma
493
Heart Failure 428
Angina
413
Coronary Artery Disease 414
Chronic Renal Failure
585
Add to your clinic problem list over time
Extra words or descriptors may be added in the “Qualifier” field and will appear in Problem list
but not be “coded”.
In this example the patient is diagnosed with hypertension as the problem but
extra information is added in the Qualifier field
The extra information in the qualifier appears visible in the problem list but does not
impact the ICD-9 coding. This patient would be included in a search for any patient with
hypertension.

Tip: Favourites can be created in Wolf by the clinic administrator in the Problem Maintenance by
adding a star icon * to the beginning of the problem list names the clinic wishes to favour. Users
need only to put a * in the problem list to bring up the favourites.
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Forming Problem Registries
There are useful searches that will support the development of disease registries. By looking in other
areas of the EMR, patients without the problem in their ‘Problem List’ can be identified.
Feature of EMR
Billing
Medications
Lab
Example 1
Data that would inform Diabetes
Mellitus Registry
Diagnostic code 250
Currently taking metformin or
insulin
HbA1c over 7 %
Example 2
Data that would inform
Hypertension registry
Diagnostic code 401
Currently taking an
antihypertensive
BP > value specified by clinic MDs
Example:
This Practice Search identifies patients prescribed Metformin or Insulin but the patient Problem List does
NOT contain Diabetes (250)
Problem List
does not contain
Diabetes
Patient is
prescribed
Metformin or
Insulin
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The bulk action feature from reporting area of the EMR is a useful tool when producing a list of verified
patients with a given condition to add it to the patient problem list in bulk.
Disease Management
Proactive panel-based care of a cohort of patients with a given condition (e.g., Diabetes or hypertension)
is enabled by certain EMR features:
 Problem list
 Rules set for a population of patients
 Pop-up notifications from Notes in Demographics (for very important concerns)
 Follow-ups, worklists
Tools for Panel Management
Clinical Decision Support: Population-wide point-ofcare reminders
Most EMRs have a tool that will search the database for specific criteria to identify patients due for
clinical service. Population-wide point-of-care reminders may be called ‘rules’, ‘triggers’, ‘alert’,
‘notification’ etc., and these are really just searches that run in the background of the EMR and provide
notifications when a patient meets the criteria.
These can be created based on internal clinic information such as charting, scanned documents, billing or
external information such as incoming lab or imaging data. These point-of-care reminders will
automatically go away when the search criteria are met. Population-wide reminders are key enablers of
proactive panel-based care. The higher the data quality in a practice the more reminders a practice team
are able to create and use reliably.
Recognizing that individual patient care will be tailored and that there are exceptions to the rules,
reminders have the ability to be individualized for patients and modes of documenting exemptions.
Individual Patient Alerts
At the individual patient level, EMRs have the ability to create a note or alert for an individual patient.
Individual patient alerts can vary from critical pop-ups to notes that appear in certain areas of the EMR
such as scheduling, appointments or in charting.
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Clinical documentation so that data may be
searched
EMR users need to be aware of the search capabilities of their EMR. Where information is entered
matters! In general, fields that can inform a search or report include:
 Drop down lists
 Radio buttons
 Boxes only designed to record certain information like blood pressure or weight
 Templated fields in an exam template
Even in an area where free text can be entered, if certain information is entered with a consistent term, it
may be searched. Where common repeated text (macros or auto-replace) is used, it may be uniquely
searched.
Important Wolf Help File: Practice Search Parameters
Scanned Documents
Every clinic receives electronic faxed documents which get linked to individual patient records. The
naming or indexing of these documents as they are attached should enable two processes:
1) When a provider is viewing the patient chart they should easily identify the information and be
able to find it quickly or by filtering the view to show documents with the same keyword (e.g., all
mammograms, colonoscopies, etc.)
2) In the Practice Search it is possible to produce a list of patients that have a type of linked
document within a period of time. These same document names can be used to create a
population-wide point-of-care reminder or to populate a flowsheet.
Key principles for linking scanned documents







Create a list of acceptable document keywords that can be used at the practice that is agreed
upon by the clinic team (clinicians and team members). See Appendix A for examples.
Once the list is established, Use the drop down list in the EMR; avoid free typing
Certain clinical reports need to be distinguished to enable panel management and Rules
o Distinguish mammogram results from all diagnostic imaging
o Some consult reports need consistent naming:
 Colonoscopy reports
 Flex sigmoidoscopy report
 Colposcopy report
Provide training to staff and place a printed list of acceptable keywords with indexing tips at every
workstation where documents get linked to patient charts
Name the document based on type of consultation rather than the name of the consultant
o E.g., If a referral is for gastroenterologist consult, name the letter “Gastroenterology
consult” not “Dr. Black consult”
Only central clinic EMR administrator(s) should be allowed to add, delete or modify the main list
of keywords
Free text can be added in the Notes field
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Use up to 3 keywords.
Add free text in
Notes field. Notes
searchable in
Documents tab of
patient chart in
Search field.
the
are
the
the
the
Manual Entry of Lab Data
Most EMRs have the ability to manually enter lab data that may be received by fax or completed within
the clinic. Data may be received by fax due to the lab originating from a source outside the region. If this
lab data is entered as a “Manual Result” rather than a scanned document it can usually be trended and
searched.
Manual results may be entered from the Right Mouse SMART Menu while in a patient chart.
Wolf is set up with many lab results
but additional types of labs or data
can be configured in Configuration
with advanced training. Some clinics
have set up to record screening offers
as manual results.
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Measurement
While moving toward the Patient’s Medical Home, a practice or team will not know how they are doing
unless they measure for improvement. Reporting measures can provide information to inform both short
term process improvements as well as long term effectiveness. Example measures are:
Verification Rate
One tool that can be useful is to measure how often the team is verifying the patient demographic
information (address and phone) and physician attachment. When a clinic is new to patient verification it
can be reported from Practice Search. For example a team that wants to measure how they did in a week:
# patients verified this week
# patient visits this week
x 100 = verification rate (%)
Tip: The numerator is the top
number in the fraction; the
denominator is the number
on the bottom.
To determine the numerator, the number patients verified this week, use Practice Search to identify
“Patient Data Verified” and choose “In Last 1 Week”. The first time this search is done, produce the list to
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verify that the results are what you are seeking but the fastest way to get the number is to use the
Demographic Viewer.
IMPROVEMENT TIP: Display your
results in a Run Chart over time to
show your improvement in verifying
patient data.
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To determine the denominator, the number of patients that had a visit this week, use Practice Search to
identify “Last Visit” and choose “In Last 1 Week”.
A clinic may also have an expectation for improvement over a period of time and can determine if they
are meeting their goals. For example if a practice has an expectation that their verification rate over a
year should be 95% the formula would be:
# patients verified in the last year
x 100 = verification rate (%)
# patients with a last visit in the last year
Screening Rate Based on Completed Screens
A practice will also find that they are able to measure rates for preventive screening care. Measuring
completed screens looks for completed results. The generic equation is:
# patients in eligible population with a
result during the screening interval +
# patients in the eligible population*
+
x 100 = screening rate (%)
The screening interval is the time frame during which the screening maneuver should be done
* The eligible population would include all the active, paneled patients for a provider whether they came
into the clinic or not, as all rates are calculated over the paneled population.
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Example 1: Dr. Adams wishes to calculate the completed blood pressure screening rate for his active
paneled adult patients. Blood pressure should be measured annually (ASaP)
# active adult patients* (18 +) with a BP result in the last year x 100 = BP screening rate (%)
# active adult patients* (18 +)
* Attached to Dr. Adams in the EMR
To calculate the top number of the fraction, identify Dr. Adams pts 18 + with any BP result:
This search identifies
all the patients 18+
attached to Dr.
Adams with (any) BP
result in the last
year. If status is used
in the practice it
must be applied in
the search as well.
To calculate the bottom number of the fraction, identify Dr. Adams pts 18+:
This search identifies
all the patients 18+
attached to Dr.
Adams. If status is
used in the practice
it must be applied in
the search as well.
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Example 2: Dr. Brown wishes to calculate the completed diabetes screening rate for her active adult
paneled patients. Diabetes screening is:
 appropriate for adults 40 +
 recommended once every 5 years
 completed with a fasting glucose, hemoglobin A1c result or a diabetes risk calculator score
# active adult* patients (40 +) with a fasting glucose
OR HbA1c OR diabetes risk score in the last 5 years
x 100 = Diabetes Screening Rate (%)
# active adult patients* (40+)
* Attached to Dr. Brown in the EMR
Calculating a Screening Rate Based on Offers of Screening
Care
Practitioners participating in the Alberta Screening and Prevention improvement project will include both
completed screens and offers of the screen. In this case, to measure with the EMR there must be a place
that declined, deferred and exemptions for screening are reliably recorded. In this case the generic
equation is:
# active adult patients with an offer of screen
or completed screen during screening interval x 100 = screening rate (%)
# active adult patients
It is recommended to use the chart audit methodology2 instead of EMR measures if the offers of screening
care are unable to be searched in the EMR.
Disease Management Rate
EMRs are capable of measuring around disease management parameters provided the information is
entered in a place where it can be searched.
Example:
Dr. Brown wishes to measure how many of her active paneled patients with diabetes have an HbA1c
result below 7% in the last year.
Generic equation:
# active patients* with diabetes+ with an HbA1c result below 7% in the last year x 100 = rate (5)
# active patients* with diabetes+
+
Patients are identified as diabetic when Diabetes is listed as an active problem in their Problem List
2
See ASaP EMR Chart Review Instructions: http://www.topalbertadoctors.org/file/asap-chart-reviewinstructions-emr.pdf
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Advanced Features of Wolf
Wolf has some advanced features that will assist in Patient’s Medical Home work.
Custom Templates
Clinics can use the Custom Exam Subform Wizard accessible from a physician workdesk in Configure >
Custom Exam Forms. This feature allows the clinic team to create custom exam forms that are accessible
to the providers and team members. For team members that enter vitals there is a Structured
Examinations drop down menu that allows access to entry of exam forms.
Many clinics have created a custom ASaP exam form or downloaded the copy from the TOP web site.
Those with advanced training can share exam forms with others.
See the Wolf video Custom Exam Fields in the Wolf EMR Community.
See the Wolf Help file: Custom Exam Subform Wizard
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Flowsheets
Wolf has some pre-built flowsheets, a table that displays data pulled from information that is already
entered into the Wolf patient chart, and tracks it over time. Many are pre-built in the EMR and are called
CDM Flowsheets. See the Wolf Help file CDM Flowsheets.
Flowsheets can also be custom created by the practice to pull from history, examination fields,
medication, lab, consultation, vaccination, preventive care and documents. When there is good
standardization in place and patient data is entered consistently, the clinic is in a good place to use
flowsheets for those areas. Because flowsheets consolidate a great deal of patient information on one
place they are highly valuable for screening (ASaP) and chronic disease management.
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Appendix A: Lists of scanned document index
words/keywords
These examples are from real clinics.
Example 1:

























ALLERGIST
Appointment
Appt Confirmation
CARDIOLOGY
Chart
Colonoscopy Report
Colposcopy Report
Consult Letter
CT Scan
DERMATOLOGY
Discharge Summary
Driver’s Medical
ECG Graph
ECG Report
ENDOCRINOLOGY
ENT
Forms
GASTRO
GEN SURGERY
INTERNAL MED
Lab
Lab – Provincial
Mammogram
MRI
Neurology

























Neurosurgery
Notice of Admission
Notice of Discharge
OBGYN
OPD Sheet
Ophthalmology
OR Report
ORTHO
Paps
Parking Placard
PEDIATRICS
PLASTICS
Prenatal US
Pre-op Medical
Referral
Report
Requisition
RHEUMATOLOGY
Rx Adaptation
Rx Refill
Ultrasound
UROLOGY
Vascular
WCB
Xray
EMR TIP SHEET | AUGUST 2016
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Example 2:





































Admit
Air Contrast
ALT
Anti-HIV
Anti-Nuclear (ANA)
Appointment Notice
Attending physical
statement
Audiology Report
Beta HCG
Biopsy
Blood Culture
Blood Type
Blue Cross Authorization
Breast Ultrasound
Body Fluid Culture
Bone Density
Bonnyville Cancer Centre
Bubble Pack
Authorization
C-reactive Protein
Cat Scan
CEA
Cervical Culture
Chart Notes
Chart Request
Acknowledgement
Chemistry
Child Welfare Medical
Chlamydia
Claims Management
Program
Colonoscopy Report
Colposcopy Report
Consult
Creatinine
Critical Care Line
Cross Cancer
Cytology Report
Diabetic Consult
Discharge Instructions






































Discharge Summary
Double Contrast
Driver’s Medical
ECG
Echocardiogram
EA screen
Endoscopy
Ferritin
Free testosterone
Gastroscopy
GC Probe
Gynecological Cytology
Report
HBA1C
Hematology
Hepatitis
Home Care
Imaging
Influenza
INR
Iron and TIBC
Lipid Testing
Mammogram
Medical release and
report
Medications
Mental Health
Microbiology
Millard Health WCB
MRI
MRSA
Newborn Metabolic
Screen
NIHB Drug Exception
No Show
Occult Blood
Oncology Imaging
OPD
Operative Report
Ova & Parasite
Paps
EMR TIP SHEET | AUGUST 2016





































Pathologist Comment
Patient Photo
Perinatal
Phenytoin
Physician Admit Advice
Pre-op medical
Prenatal US
PSA
Psychogeriatric Consult
RAAPID North Patient
Summary
RAH
Rapid Plasma Reagin Test
Release of information
Rx adaptation
Rx request
Serum Protein Elect.
Slick
Sputum Culture
Stool Culture
Superficial Culture
Surgical Pathology Report
Syphilis
TB Update
Throat culture
Tom Baker Cancer Centre
Troponin
TSH
UAH
Ultra Sound
Urethral Culture
Urine Microalbumin
Vaginosis Screen
Vital Aire
VRE
WCB
Wound Culture
X-ray
Page | 59
EMR TIP SHEET | AUGUST 2016
Example 3:


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Appt Notice
Attending Physician Statement
Audiology Report
Blood Glucose Readings
Blue Cross
Bone Density
Cardiology
Chart Notes
Colonoscopy
Complex Care Plan
Consult
Cross Cancer Inst.
CT
Discharge Summary
Driver’s Medical
Echocardiogram
EKG/ECG
Email
Emergency Record
Exercise Stress Test
Form
Framingham Risk Assessment
History Sheet
HIV Test Results
Holter Monitor Reports
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Home Collections Confirmation
Injection
Labs
Letter
Mammogram
Medical Legal
Medical Summary
MRI
Operative Report
Outpatient Report
Pacemaker Clinic
Paps
Patient Information
PCN After Hours Clinic
Prenatal US
Pre-Op Medical
Procedure Letter
Prov. Lab Results
Referral
Rx
Treatment Consent
Ultrasound
Vasectomy
WCB
Xray
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Appendix B: High Value Tips
Notes (in Patient Maintenance)
Patient Maintenance has a Notes tab that can support panel management. Some notes need to be issued
at the patient level. Active Notes will display at booking and confirmation, arrival or billing. Some
important clinical notes may need to display at different points.
Example: A physician has a few patients in the clinic with Multiple Sclerosis. Some are on a selfmanagement protocol for urinary tract infections and others are not. For patients that are not on selfmanagement protocol the following note appears in Patient Maintenance and will pop up at Booking and
Confirmation “MS Patient – NOT on self-management protocol for UTI – Urgent same day appointment
needed for urinary tract infection.”
Configuration Settings
Each user can adjust their workdesk settings to make their day go faster but adjusting settings in their
workdesk from Configure > Configure WorkDesk.
SMART (Right Mouse) Menu
You can access the SMART Menu (also known as the right-click menu) from almost anywhere on the
Physician or MOA WorkDesk by right-clicking your mouse when a patient is selected or highlighted. This
menu can be configured so that the user only sees the menu items most frequently used. To adjust from
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the WorkDesk select Configure > Configure WorkDesk. In the WorkDesk User Preferences select Manage
Right-Click Menu
Each user selects only those items in
the right mouse menu they use
frequently. Every use must set this
individually.
All menu items are available through
“Show All Menu Items” at the bottom
of the list.
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Auto-Text Replace is available in the Spell Check tab.
Anything that a user types frequently can be made as Replace Text. To create a new Replace Text:
1) Plan a code that would not otherwise be typed
2) Click the Keyboard icon
3) Fill in the Replace column
4) Fill in the Replace Text column with the long note. This may be planned in Word or Notepad and
copied into the Replace Text area.
It is worthwhile setting this up as it will provide great efficiency over time.
See Wolf Help Files: Configure WorkDesk – Spell Check tab
Also recommended: on the Visit Exams tab select only those visit exams used by the user.
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Exam Templates
Wolf-created and user-created custom exam templates can assist in collecting information in a
standardized format. Wolf has many templates that are available to MOAs from the F6 Vital Entry screen
in the bottom right hand corner in the Structured Examinations Field:
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For users on the Physician WorkDesk, these exam templates are available when selecting an exam
template.
The list of exam
templates can be
configured by each
user in Configure >
Configure WorkDesk .
In the WorkDesk
Preferences window
select the Visit Exams
tab. Select only those
exams the user wants
visible.
Tips in using Exam Templates:
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Double click in any field to see a history of values of that field
When an MOA enters data from the F6 entry, the information will be visible in the Physician
WorkDesk in an encounter.
On the Physician WorkDesk, a user can close one exam template and open a second or third in a
single visit for additional entry
Each field is reportable from Practice Search in the Exam Findings search parameter. Select Exam
Findings Values.
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