Topics Frequently Asked Questions Search:  
  1. Explain the process of taking patient photo at registration.
    Answer:
    1. After filling all the details required on the registration form, click on save. (Because
      photo can be attached only to an existing patient record).
    2. The “clip (attach)” button near the photo heading now gets enabled.
    3. Check that the digital camera setup is ready and connected to the to the computer.
      Start the digital camera software. Set the folder where the clicked images should be
      saved.
    4. Now take the patient’s photograph using digital camera software.
    5. If prompted by digital camera software for file name, accept the default name and accept the default file type. To conserve space recommended format is .jpeg, which is 20 times smaller in size than .bmp using appropriate digital imaging software such as “MS Paint”. The image size recommended is width 220 pixels, height 200 pixels.
    6. Now click on the “clip (attach)” button near the photo heading.
    7. A window pops up. Click on the browse button.
    8. Now select the folder and the image file (patient photo just clicked) from it and click on open.
    9. To view the photo, click on the “lens” button besides the browse button.
    10. The photo is seen in the window below it.
    11. If ok, click attach button or reselect the appropriate photo.
    12. Clicking attach button, attaches and saves the photo.
    13. Close the alert pop up by clicking Ok. This also closes the attach photo pop up.
    14. The photo file is now uploaded to the Application server at the location:
      “\prognocis\prognocis2\datafiles\patientphoto” with a system defined name.
    15. The registration form window is now seen with the photo attached.

    Note: The registration window may show the photo area with scrollbars if the photo size is larger then the designated area (220 x 200 pixels). Once a photo is attached, the original image saved by the digital camera software, is no longer required and can be deleted. If the attached image is not appropriate, the user may attach an image again, the old image on the server will get over written with the new image.
  2. Explain the process of taking pictures of patient in exam room.
    Answer:
    1. Click on the pictures option in Encounter menu.
    2. Check that the digital camera setup is ready and connected to the to the computer.
    3. Start the digital camera software. Set the folder where the clicked images should be saved.
    4. Now take the picture(s) of the patient’s affected area using the digital camera software.
    5. If prompted by digital camera software for file name, accept the default name and accept the default file type (to conserve space recommended format is .jpeg which is 20 times smaller in size then .bmp using an appropriate digital imaging software such as “MS Paint”).
    6. Click add new.
    7. A window pops up. Click on the browse button.
    8. Now select the folder and the image file (patient picture just clicked) from it and click on open.
    9. To view the photo, click “lens” button besides the browse button.
    10. The photo is seen in the window below it.
    11. If ok, click attach button or reselect the appropriate photo.
    12. Clicking attach button, attaches and saves the photo.
    13. Close the alert pop up by clicking Ok. This also closes the attach photo pop-up window.
    14. The photo file is now uploaded to the Application server at the location:
      “\prognocis\prognocis2\datafiles\pictures” with a system defined name.
    15. Repeat steps 6 to 14 to add more pictures.
    16. The pictures window is now seen with the pictures attached.
    17. To enter comments for a picture, click on that picture.
    18. A pop-up window opens.
    19. Click on the area of the picture to place the pin there.
    20. Now, enter comments (also, adding of predefined phrases is possible by clicking on the search button and selecting the desired ones from the pop up) in the area provided below it.
    21. Click Ok to save the comments.
    22. The doctor can now draw on the pictures and also view a slide show of all the images.

      Note:       The picture size must be restricted to 455 pixels height and 560 pixels width. Photos bigger than this size will be truncated when shown to place pins.
      When all pictures are shown on the main page, they are scaled down; depending on the number of rows & columns and the real estate available, as such there could be a distortion.
  3. Explain the process of scan & attach Lab results. View it and use it in transcript.
    Answer:
    1. Start scanning software.
    2. Set the folder where the scanned image should be saved.
    3. Scan the copy of the lab result.
    4. When prompted for file name, accept the default name and accept the default file type (recommended .jpeg).
    5. If the pages are more than one, scan all of them with the default name and save them in the same folder (path given above).
    6. After all the pages are scanned, open a new Word document.
    7. Insert all the scanned images of the pages from the folder in step 2.
    8. Save it by a name you wish.
    9. Go to Lab Results and click on Attach tab to attach the above word doc file.
    10. Click on Save.
    11. The file is now uploaded to the Application server at the location:
      “\prognocis\prognocis2\datafiles\labresult” with a system defined name.

      Note:Only one file can be attached to a Lab Result. In case the result comes in as a single page, it is not necessary to copy this scanned image in a word file. This image file can be directly attached to the results.
  4. A Doctor needs to be reminded that results pertaining to last encounter need to be reviewed now (although he had approved it a few days earlier). How do we implement this? How & where do we accept his review comments?
    Answer:
    On the encounter TOC, the Lab Result and Rad Result options display the count of orders which are yet to be reviewed. This way the doctor is reminded that he has to review the Results received. What is not obvious though is if all the Pending for Review Orders were from the last encounter, or a few of them were pending for a longer time. Lab Results has a field to accept one common review comments for all completed but Not reviewed Lab Orders. This field is invoked in a pop-up window from the Lab / Rad Results screen. This is invoked only if the user (Doctor or Nurse) goes to the Results screen from the Encounter TOC (Lab/ Rad Result) option (not from CPOE > Lab Results)
  5. When we click on TOC Lab Order, what elements are shown when logged in user is Doctor / Nurse / Others?
    Answer:
    Lab/Rad Order invocation from main menu CPOE
    If logged in user is Doctor:
    He can edit / see all Orders where
    He is the Ordering Doc AND
    Order Status is Entered / Approved / Ordered

    If logged in user is Nurse:
    She can edit / see all Orders where
    Order Status is Entered / Approved / Ordered
    Nurse has access to all Orders irrespective of the Ordering Doctor. She gets a Selection List Box on the toolbar to select orders for a selected doctor.

    Others are not expected to have access to this option. If they have the rights, they will be treated as Nurse.

    All Orders are shown in Search (and Next, Previous buttons) in descending Order of Lab/Rad Order Number. Note the Order Number is generated. Each Doctor can have a different Prefix. If the log in person is other than a Doc this can create a problem to the extent that the latest generated Order will not be at the top of the search list. A good solution is to have a single Prefix for the clinic, rather that specific to each Doctor.
    Order Lab/Rad Invocation from Encounter TOC
    All orders that belong to the current encounter, irrespective of their order status.
  6. If nurse is ordering Lab tests what happens to Doctor’s Preferred Tests?
    Answer:
    The test selection is done through a Lab Test search. Hence when a nurse logs in to create a lab order she can view the Attending Doctor’s preferred Lab Tests.
  7. Can a panel test be hidden? Can a test included in a panel be hidden?
    Answer:
    No. If it is a panel, the value in the hide check box is not considered. Hidden flag is applicable only for Both and HL7 Order Tests. A test included in a panel can be hidden. Hidden does not imply that the test is no longer in use. It just means that since it is part of Panel; do not show it explicitly in the test selection list again.
  8. What happens if a Panel constituent tests hidden status is changed after each of Lab Order Save, Approve, Send, Receive Results, Complete? Will it affect the Transcript?
    Answer:
    No problem. If changed before send, the Order Selection list will Show / Not Show the test.
  9. Rule for keeping Comments button enabled/disabled in Lab Order?
    Answer:
    Button is normally enabled. Once Approved, Comments cannot be modified. But how does anyone know if there are any comments? So once approved, if there were no Comments entered it will be disabled, else it will remain enabled, however on opening the Notes screen, the OK button will be disabled, so that no changes are made.
  10. Why is a Doc entry editable but not HM in PHS?
    Answer:
    The Doctor makes Tests entry explicitly; hence he has the right to change it. When he prescribes a drug say to reduce the blood sugar, he may advice the patient to check the blood sugar every week. He does this by scheduling this test. In all such cases the frequency will be a small duration, typically in days.
  11. What is the rule for default Sig / route/ frequency?
    Answer:
    The User can select drugs from Doctors Preferred list, or list of all drugs. The system maintains the Last used Sig / Route / Freq / Days for both and these are shown by default. Since the system knows from which list the Drug details have come, on Save it updates the corresponding list with current details.
  12. What is the Formula for computing Issue Quantity?
    Answer:
    Issue Qty = Sig * Freq * No of Days
  13. Where does the Default Pharmacy in Rx come from?
    Answer:
    The pharmacy selected in the Prescription of each encounter of a patient, is stored in the Encounter Master. The last used Pharmacy is also stored in the Patients master. The next time any doctor writes a prescription for the patient, the default Pharmacy comes from the Patient Master.
  14. Is it possible to print Rx separately for OTC, Prescribed and DEA restricted Drug categories?
    Answer:
    No. There is no filtering on type of drugs. However as per the requirements in many states, it is possible to print Rx separately for each drug. To do this the user has to ensure while designing the Prescription template the first line is the Tag [SEC_RX_DET_START] and the last line is the Tag [SEC_RX_DET_END].
  15. Give the consolidated list of validations made in close encounter.
    Answer:
    Only the Attending Doctor can close an encounter.
    All Lab / Rad Orders, Prescriptions and Letters-Out pertaining to this encounter must also be completed. The system tracks and gives the documents for the current encounter Entered, Approved and Send.
    Consider the flag in Settings > Configuration > Properties > enc.close.orderstatus. If it is set to A, count of Entered documents must equal count of Approved. If it is other than A, count of Entered documents must equal count of Send.
    If the Encounter Type has Appointment Duration > 0 (i.e. it is other than Refill Request, Telephone encounter) and Billable is true,
    If enc.close.Icd.must is Y then an Assessment ICD is mandatory.
    If enc.close.Enm.must is Y then an E&M code is mandatory.
    Consider the values in Settings > Configuration > Properties > enc.close.checkifdone. The system checks for all the specified options and warns the user about the modules, which have not been done.
    The value in Settings > Configuration > Properties > enc.close.letterprompt is considered. Accordingly, if the letter to the referring doctor has not been sent for that particular encounter, the system generates a warning message, offering to internally generate a letter and send it to the referring doctor.
  16. What are section tags? Where and how are they used?
    Answer:
    The section tags server the purpose in printing Lab Order, Rad Order, Prescription and Encounter Reports. All these logically consist of printing one common Header/Footer and printing a number of detail lines or transactions. For example, in a Lab Order we need Clinic, Patient, Doctor, and Lab Name Address etc as part of header. Details of each test to be printed become part of the transaction record. There can be any number of transaction records in a Lab Order. But for this small conceptual change, programmatically Order printing is in no way different from Progress Notes generation. So we add a simple rule, the program will ensure that all Tags between corresponding Section Start and Section End tags will be processed for each Transaction record, all other Tags are processed only once. So in our example of Lab Order while designing the template keep Tags for Test details between SEC_LAB_DET_START and SEC_LAB_DET_END, other Tags (for header / footer) can be before or after them.
    It should be obvious to guess the purpose of the following, and use them in the respective templates only.

    SEC_LAB_DET_START Lab Order Tests Start
    SEC_LAB_DET_END Lab Order Tests End
    SEC_RAD_DET_START Rad Order Tests Start
    SEC_RAD_DET_END Rad Order Tests End
    SEC_RX_DET_START Rx Order Drugs Start
    SEC_RX_DET_END Rx Order Drugs End
    SEC_ENC_REP_START Encounter Report Start
    SEC_ENC_REP_END Encounter Report End