HEALTHone User Manual - HealthOne Ireland User Group

HEALTHone User Manual - HealthOne Ireland User Group

Health One

Version 6.0 User Manual. Copyright

2010 Helix Health Ltd

HEALTHone User Manual

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Health One

Version 6.0 User Manual. Copyright

2010 Helix Health Ltd

Table of Contents

1.

Terms and conditions

2.

Introducing

HEALTH

one ™

3.

Getting Around

4.

A Patient Visits

5.

A New Patient

6.

Adding Basic Medical Information

7.

Analysing Patient Information

8.

Prescription Manager

9.

Multiple User Appointments

10.

Legacy Appointments

11.

Correspondence

12.

HEALTH

one

Procedures

13.

Problem Orientated Medical Records

14.

Billing

15.

Managing Patient Files

16.

Vaccination Techniques

17.

Plan of Action

18.

Query Plus

19.

Mail Merge

20.

Miscellaneous

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TERMS AND CONDITIONS

IMPORTANT NOTICE

THE ATTACHED UPGRADE IS SUPPLIED TO YOU UNDER THE

TERMS LISTED BELOW. USING THE PRODUCT INDICATES YOUR

ACCEPTANCE OF THESE TERMS AND CONDITIONS. IF THEY ARE

NOT ACCEPTABLE YOU MUST RETURN THE UNUSED SOFTWARE

TO THE PLACE OF PURCHASE AND YOUR MONEY WILL BE

REFUNDED.

COPYRIGHT - SOFTWARE

This software upgrade is Copyright (C) 1987-2008, and all rights are reserved by Helix Health Limited (SSSL) or its affiliates. SSSL grants a non-exclusive right to use the programs in accordance with the terms and conditions listed here to the purchaser of the programs or a transferee (in accordance with condition 4 below). All rights not specifically granted under these terms and conditions are reserved by

SSSL or its affiliates.

COPYRIGHT - MANUAL

This manual is copyrighted (C) 1987-2008 and all rights are reserved by

SSSL. The document may not be copied, photocopied, reprinted, translated, reproduced or transmitted, in whole or in part, without prior consent, in writing, from SSSL, except where the copy is to be used, by the purchaser or transferee, for the purpose of utilising the software more efficiently.

SOFTWARE USE

Only one copy of this software may reside and be used on a single machine at any one time. Modification is expressly prohibited. The software may only be copied for the purpose of backup for archival purposes but may not be distributed or lent to a third party except under the terms of condition 4 below. The software cannot be lent, leased,

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SOFTWARE TRANSFER

The software may be transferred to a third party provided all copies and the originals are transferred in the process and that the third party is shown and accepts these conditions. Without such a transfer, the third party will not be authorised by SSSL to use the software and will be in breach of the copyright of the software. In such a case, the purchaser will be held responsible for any loss or damage suffered in accordance with condition 6 below.

UPGRADES

You are only entitled to upgrades of the software if you are properly licensed to use the software and provided that you have a valid support contract with SSSL, or its affiliates, or you have paid SSSL an agreed license fee for the upgrade.

BREACH

If the purchaser or transferee acts in breach of any of these terms and conditions the purchaser or transferee shall indemnify SSSL against all loss suffered, including loss of profits, and the purchaser or transferee shall return to SSSL all lawful and infringing copies of the software, including the dongle.

LIABILITY AND WARRANTIES

The Software is supplied to you on an 'as is' basis and it is up to the purchaser or transferee to satisfy himself/herself that the software meets his/her requirements BEFORE it is used. Although the software is tested before release, no claim is made regarding its accuracy. SSSL, its affiliates, directors or any of the software distributors do not assume liability for any loss or damage arising from the use of the software, inability of the purchaser to use the software correctly or failure of the software to function correctly. This includes loss of profits, business interruption, loss of business information, direct or indirect damages for

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The Software License Agreement is governed by the laws of the

Republic of Ireland.

ADDRESS AND CONTACT NUMBERS

Helix Health Limited,

52, Broomhill Road,

Tallaght,

Dublin 24.

Ireland

Phone: (353)-1-4633000

Fax: (353)-1-4633011

Home Page: www.helixhealth.com

Email: [email protected]

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Introducing

HEALTH

one

TM

Concepts & Structure

HEALTH

one

™ is structured around the Health Care Record and the various elements which form it. Being familiar with this and the terminology that is used will make using the product easier and the

HEALTH

one ™

documentation straightforward to understand. Spending a few moments in this section before proceeding will be very worthwhile.

This session is primarily intended to introduce the basic structure and terminology used in HEALTH

one ™

. The question how is addressed in the sessions that follow.

Health Care Record (HCR)

This is equivalent to a patient‟s folder in your manual records; in fact it is structured in a similar manner. Below is drawn a patients folder which we will compare to the HEALTH

one ™

Health Care Record (HCR) on the next page

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Patient’s Folder

Typical Structure

Front Cover

Basic Administration

Information

First Name

Surname

Name

Address

Sex

D.O.B

Occupation

…etc

Inside Front Cover

Basic Medical

Information

, i.e.

Medical History

Surgical History

Tobacco

Alcohol Consumption

Blood Group

Allergies

…etc

Inserts

Consultation Records

e.g. S. O. A. P.

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Health Care Record (HCR) ..continued

Health Care Record Structure

The HEALTH

one

Health Care Record is divided into 2 chapters,

Administrative and Medical, which contain one or more pages of information. Each chapter and page has an icon (small picture) that represents it on the HEALTH

one ™

screen. These icons are shown opposite the parts of the HCR they represent below:

Administrative Chapter

The first page of the Administrative Chapter contains the basic administration information needed to create the patients file, Name. Date of Birth, Sex, Address, Occupation etc. Similar to the front page of a patient‟s folder.

Medical Chapter

The first page in the Medical Chapter contains the Basic Medical

Information, i.e. medical history, surgical history, allergies, blood group etc. This information is similar to the Inside Front Cover of a patient‟s folder.

Page Two onwards details each consultation/contact with the patient. It is worth noting that HEALTH

one ™

will enter a new page in this chapter for any reason to update the patient‟s record, i.e. a repeat script, a consultant‟s report, a call out to the patient at home etc, not just for a consultation where the patient visits the surgery. These are similar to the inserts used to record a patient‟s visit in your manual folder – the main difference being that HEALTH

one

uses a page per contact, whereas your folder inserts could record several contacts with the patient.

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HCR Appearance on Screen

The HCR screen is divided into 3 principal areas called panels. These are the Problem, Transaction and Item Panels. We need concern ourselves only with the Transaction Panel, where the chapters and pages are displayed, and the Item Panel where the content of the page selected in the Transaction Panel is displayed.

Health Care Record (HCR) ..continued

HCR Appearance on Screen

The Item Panel on the right will display the contents of any page that is currently selected in the Transaction Panel. We will explain later how to do this, but for now look at the next three figures. Each displays a different page in the Transaction panel (note the current page is shown

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Fig. 1 Administration Page

Administration page selected.

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Fig. 2 Medical Chapter Page One

Basic Medical Information

First Medical Page Selected

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Health Care Record (HCR) ..continued

HCR Appearance on Screen

Fig. 3 Medical Chapter Page Two

A Consultation

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The Transaction

This is simply the general name given to any page in the Health Care

Record.

Whenever a

new page

is required in the patient‟s HCR, we simply insert a new transaction. When a new medical transaction is created it will appear in the Transaction Panel underneath any existing medical transactions (these are listed in date order).

Look at the next illustration. Our patient visited once again and we recorded this in his/her HCR by the addition of a medical transaction.

The technique of inserting a new transaction is explained in a future session.

The new transaction appears as a new

page

in the medical chapter:

Fig. 4 Medical Chapter Transaction Three

A Further Consultation

3rd Medical Transaction Selected

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The Item

This is the name we use to describe the various types of information recorded in any transaction. Look at fig.4 above. The contents of the selected transaction (Medical Chapter Page 3) appears in the Item Panel on the right and is comprised of 4 separate Items:

subjective symptoms:

,

objective findings:

,

assessment:

and

plan of action:

.

Items are easy to recognise by their distinctive icon. Each type of item has a unique name followed by a colon (:).

Fig.5 The assessment Item

You can think of an Item as being a container or box. The writing that appears to the right of the Item Name, i.e. after the colon (:), is its contents.

Fig.6 The assessment Item

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The Item ..continued

The Item Selector

HEALTH

one ™

has a dictionary of different Item Names. When you are entering information into a Transaction (page) in a patient‟s file you can add an item by selecting it from the dictionary. The Item Selector displays the dictionary contents and allows you to easily locate the Item you require.

The icon on the left will be displayed on your computer screen (exactly where it is displayed on the screen is not important at the moment) and by simply clicking on it with your mouse the Item Dictionary will be displayed:

Fig. 7 The Item Selector Window

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The Sequence

A sequence is a predetermined set of Items that have been grouped together to suit a particular task.

With the exception of the Administration page all other transactions are blank when first created. That is they contain no Items at all. This allows for great flexibility, for example, when a pregnant female patient visits, you would create a new transaction in her file that adds a page in her

Medical Chapter. Next you select the Sequence, which best suits the reason for her visit

– this is done using the Sequence Selector.

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The Sequence Selector

The Sequence Selector displays all the names of Sequences relevant to what you are currently doing, i.e. the list displayed will be dependent upon whether you are working on a page in the Administrative or Medical

Chapters. Below is the list that will be displayed by the Sequence

Selector for a medical transaction. In our example, the female patient is visiting for an antenatal check up and the „Antenatal Care‟ Sequence is shown selected:

Fig.8

Sequence Selector Window

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The Aggregate Item

We mentioned earlier that an Item could be considered as a box or container. The aggregate Item is no more that an Item that has more than one container. These are useful when recording natural groups of information. Take Blood Pressure as an example, we know we need two values to record this:

Systolic and Diastolic pressures

To record this we don‟t have to use two separate items, one for each pressure, we can simply use an Aggregate Item.

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The Aggregate Item Selector

In a manner similar to the Item and the Sequence encountered earlier, the Aggregate Item also has a selector. By clicking on its icon (illustrated opposite) the selector window will be displayed:

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To Summarise:

The basic building block for HEALTH

one ™

is the Health Care Record.

This can be considered as the equivalent of the patient‟s folder in the manual filing system.

The Health Care Record is divided into 2 Chapters:

The Administrative Chapter

The Medical Chapter

Transactions (pages) are created in these Chapters.

The transaction in the Administrative Chapter contains the basic patient information needed to create the Health Care Record:

Patients First Name

Patients Surname

Patients Sex

Patients Date of Birth as well as additional administration information such as occupation, name of spouse, GMS number etc.

The first transaction in the Medical Chapter contains the patient‟s basic medical information, like: Medical History, Surgical History, Allergies,

Blood Group etc.

Transactions two onward in the Medical Chapter each record a contact with the patient. This contact can be for any reason, not simply a visit to the surgery.

The Transaction is just a term used by HEALTH

one

to mean „page‟.

Whenever a new page has to be inserted into the HCR we instruct

HEALTH

one ™

to create a New Transaction.

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Transactions contain Items.

An Item can be considered as a container or box. Each type of Item has its own unique name followed by a colon (:). We place information into

Items. For example, the

Date of Birth:

Item will contain a date.

A Sequence is a predetermined set of Items, grouped together to suit a specific task. There is no fixed number of Items grouped together in a

Sequence, as many or few as are required to suit the task.

An Aggregate Item is an item that will hold more than one piece of information. An example is Blood Pressure where both systolic and diastolic pressures need to be recorded.

These then are the basic structural points around which HEALTH

one ™

has been designed. In the sessions that follow all of these points will be repeated.

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Own Notes

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Getting Around

Session One introduced the Health Care Record and terminology used in

HEALTH

one

TM

.

In this session we will introduce you to one of our patients: John Test, and learn the techniques and methods required to use HEALTH

one

TM and find your way around the program.

Starting The Program

1) Look on your desktop; can you see a yellow icon like this?

If you can, double click it to start HEALTH

one

TM

and go directly to

LOGIN below, otherwise follow steps 2) to 5) :

2) On the taskbar click once on the

START BUTTON

3) Point to Programs

4) Point to the HEALTH

one

TM folder

5) Click on the HEALTH

one

TM

for Windows

menu option

HEALTH

one

TM

starts and the Login Window appears

Login

HEALTH

one

TM has a built in security system that requires the user to identify themselves by name and password to gain access to the program. This information is entered in the LOGIN window illustrated opposite.

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Note: HEALTH

one

TM

is case sensitive when letters are used in a password.

See the Specific Tasks subjects in the Practice Management Section to find out how to change your password.

Click on the

Login

button.

If the Name and Password you entered were correct

HEALTH

one ™

allows access and the Patient Selector Window appears next.

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Login ..continued

The Patient Selector Window

Selecting a particular patient Health Care Record (HCR) is easy in

HEALTH

one

TM

. The Patient Selector Window has dynamic filters that immediately reduce the patient list to only those that match the filter.

HEALTH

one

TM

is initially configured to filter by

Surname

,

First Name

,

Date of Birth

or any combination of these, however; additional filters can be added if required (see

Adding Additional

Columns

later in this session)

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Fig. 2.1 Patient Selector Window

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Sorting the Patient List

Each column of information in the patient selector can be used as the basis for sorting the patient list. Clicking on a column name will cause

HEALTH

one

TM

to sort on its content.

Each column can have one of three states

– marked by an arrow or its absence.

1) Experiment by clicking on the Surname column heading

If initially unsorted the patient list now sorts into ascending surname order

2) Repeat click on the Surname column heading

Patient list sorts into descending Surname order

3) Repeat click on the Surname column heading

Patient list returns to unsorted state.

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Adding Additional Columns

Adjusting Column Widths

There should now be two additional columns of patient information

– however; these are not spaced correctly. Some columns are too wide for the information they display and others are too narrow. The width of each column can be altered by dragging the adjuster bar to the left of its heading.

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Selecting an Existing Patient

1) If the Surname filter is not currently selected (insert cursor flashing) click once in the white box above the column name.

Surname filter is now selected

2) Type a

T

The list of patients reduces to display only those whose surname begins with „T‟

3) Type an

e

The list of patients further reduces to display only those whose surname begins with „Te‟

Select

John Test

in the patient list.

Click on the

Select

button.

The Health Care Record (HCR) for John Test opens.

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The

HEALTH

one

TM

Screen

This is the HEALTH

one

TM screen when a patient‟s HCR is open. The three panels mentioned in session one, problem, transaction and item, can be clearly identified.

Major Areas of the Screen

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The

HEALTH

one

TM

Screen - Screen Panels

The HCR screen is divided into three separate panels: Transaction, Item and Problem.

Each of these displays a specific part of the patient‟s file (HCR) as described below.

The Transaction Panel

The Transaction Panel is used to display each event that has been recorded. A new transaction is added to the Health Care Record for any reason not simply because a patient visited for a consultation, i.e. to record an experts report, a lab result, a visit at home, an issue of a repeat prescription etc. Transactions in this panel are divided into the two chapters: Administrative and Medical.

We will look at quick ways to navigate through the various transactions in this panel later, for now:

1) Using your mouse, click once to select any transaction in the

Transaction Panel. The transaction becomes blue when selected.

2) Now use the up arrow and down arrow cursor keys on the keyboard to move from one transaction to another. The highlight moves between transactions. Notice the information in the Item Panel changes

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3) Now repeat press the up arrow until the Administrative Chapter comes into view. You can now see that the Administrative

Chapter has just one transaction and the Medical Chapter starts with the Basic Medical Information transaction.

The Item Panel

The Item Panel is used to display the contents of the selected transaction. Each transaction can contain one or more items.

Remember the discussion on this in the Introduction section.

Note: By default when you open a patient’s record, the last transaction displays. It is possible to set it to open automatically in either the Administrative or Basic Medical Information transaction if preferred. To do this click on the menu item « tools

– options » and choose from the drop down list «Open the HCR on».

The Problem Panel

The Problem Panel is used to display the patient‟s principal active or inactive medical problems. This feature can also extend to linking the relevant transactions to the condition they relate too. We will show you how this is done later. It is possible to hide this panel if you are not using it:

Click on the

View

menu and select the option Problems

Problem panel disappears.

Click on the

View

menu and select the option Problems once again.

Problem panel re-appears.

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The

HEALTH

one

TM

Screen - Using Menus

HEALTH

one

TM

menus act exactly like any other Windows application, simply click, point, click.

Figure 2.2

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1) Click once on the

File

menu at the top of the screen

2) Move the mouse to point to

Open



Sub menu appears

3) Move the mouse to point to

HCR

4) Search for John Test then click on a patient to select.

The first transaction in John Test‟s HCR is selected in the

Transaction Panel and his administration information appears in the Item Panel.

Menu States

Menus and their various options are dynamic in that they have two states, active or inactive. A menu will become inactive, and therefore unselectable, if the task they perform is not relevant to what you are currently doing.

Inactive menu options appear light grey in colour and active menu options appear black.

In some instances the menu will not be present at all. The HCR menu, for example, will not be present on the menu bar unless a patient‟s HCR is open.

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Figure 2.3 Selecting a menu option

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Short Cuts

The

HEALTH

one

TM

Screen - Toolbars

A toolbar is a strip of buttons and possibly other objects that achieve various tasks i.e. open the Patient Selector Window; create a new patient file etc. etc. The HEALTH

one

TM

Window has two toolbars: Standard and

Analysis.

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To find out what a particular button does you simply place the mouse cursor on it and an explanation of its function appears in the prompt area at the bottom of the HEALTH

one

TM

Window. Wait a few seconds and its name will appear underneath your mouse cursor.

1) Point your mouse at different buttons on the toolbars and observe the prompt area at the bottom of the screen.

Prompt area text describes button functions.

Note:The toolbars can be locked by default

– so they can’t be dragged into awkward positions. . To do this click on the menu item

« tools

– options » and tick «Lock the toolbars».

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The Transaction and Item panels also have own toolbars:

Transaction Panel Tool Bar

Item Panel Tool Bar

We have indicated the function of some of the more commonly used buttons, however, the prompt area at the bottom of the screen will display a description of each button when you point to it with the mouse and they are also described on the reference sheet.

The Item, Sequence and Aggregate Selector buttons were mentioned in the Introduction Session and this is where they are displayed on your screen. The function of each button will be explained as they are encountered in the book. In many instances the action of a button is also available as an option on a menu, you can choose whatever method you prefer to select a particular function.

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The Health Care Record Window

Navigating the Transaction Panel

Using Menus

1) Click once on the

HCR

menu at the top of the screen

2) Move the mouse to point to

Go to



Sub menu appears

3) Move the mouse to point to

End HCR

4) Click once to select.



John Test‟s last transaction is selected.

5) Repeat Steps 1)

– 4) and select other menu options. Observe the effect of each menu option.

6) Repeat steps 1)

– 4) this time selecting

Begin HCR

.

Scrolling

A scroll bar will appear to the right of the Transaction Panel if it is not possible to display all of the patient‟s transactions at one time. John

Test‟s file is a good example. He has a long medical history and has had many contacts with his doctor.

HEALTH

one

TM

scroll

bars act exactly like any other Window‟s application. You have three sets of controls:

Arrows Up/Down

: Scroll display by one transaction up or down.

Scroll Bar

: Displays information relative to its position on the scroll track.

Top, equals the beginning of the patients HCR, Bottom, the end of the patient‟s file, etc. This is dragged to its new location.

Scroll Track

: The quantity of information that can be displayed in the

Transaction Panel is moved each time the track is clicked.

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Clicking the track beneath the Scroll bar will scroll downwards and above the Scroll Bar will scroll upwards.

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The Health Care Record Window

Scroll Bars..ctnd

Practical Exercise:

1) Select the menu

HCR/Go to

and select

Begin HCR.



As you can see, the Administrative Chapter icon is not visible in the

Transaction panel. To display this:

2) Click once on the

Up Scroll Arrow

.



Administrative Chapter Icon comes into view

3) Experiment with the various scroll bar controls

4) Repeatedly click on the

Up Scroll Arrow

until the Administrative

Chapter Icon is once again visible,

Transaction Panel Filter

Transactions are listed in the Transaction Panel in chronological order.

However, HEALTH

one

TM

has a special filter function that quickly locates transactions of a particular type for you. This is handy if, for example, you wish to view just lab results, or expert‟s reports or transactions relating to a particular problem. To activate the filter you click once with the

Right

mouse key anywhere in the Transaction Panel. A menu appears and you select the

Filters

option, then the required type of filter, i.e. Lab Result. Selecting full contents will return to normal chronological view of all transactions.

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Fig. 2.4 Transaction Filter Menu

(right click mouse in panel to display)

1)

Right

mouse click anywhere in the Transaction Panel.



Menu Appears

2) Select the

Filters

option in the menu. Select

Lab Results



Just Lab Result type transactions are displayed

3) Repeat steps 1) and 2) and experiment with different selections of the

Transaction panel filter.

4) Set back to

Full contents

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Filtering Transactions by Problem

John Test‟s file has been set up to illustrate this point

1)

Right

mouse click anywhere in the Transaction Panel.



Menu Appears

2) Select the

Filtered on problems

option in the menu.

3) Now select a problem in the Problem Panel



Only those transactions that relate to the problem are displayed

4) Repeat step 3) for the other problems

5)

Right

mouse click anywhere in the Transaction Panel.



Menu Appears

6) Select the

Filtered on problems

option in the menu.



Display returns to all transactions.

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Adjusting the Display of the Transaction Panel

Adjusting Display Width

This is identical to the technique encountered earlier to adjust the Patient

Selector window. When you point your mouse at the adjuster bars the cursor will change from an arrow to one of the adjustment cursors, dependent upon which bar you are pointing at. When either of these cursors are displayed you hold down the mouse key and drag to adjust the display width, when the new desired width is reached you release the mouse key.

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1) Experiment with dragging the Panel Width Adjuster Bar.

 

The width of the Transaction Panel varies

2) Drag the Column Adjuster Bars to display all the information available for each transaction.

Transaction Properties

Whenever a new transaction is created its properties box appears. This is where you can assign a person to be responsible for it and link it to a problem if you wish

– amongst other things. It is automatically assigned the current date and time, the rest you complete yourself.

More in the next session.

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The Health Care Record Window

The Transaction Information Area

The principal information regarding a transaction is displayed at the bottom of the Item Panel in the Transaction Information Area. See Fig

2.2 in this section. This information is dynamic in that it changes according to which transaction is currently selected. When information in this area is in RED it means you do not have the authority to change it

When displayed in BLACK you do.

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Viewing Transaction Attributes

1) Select any transaction

2) Click on the

Attributes Button



Selected transaction‟s attributes displayed in the Transaction

Properties dialogue box.

3) Click the

Cancel

button to close the dialogue box.

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The Health Care Record Window

The Item Panel

As you now know, transactions form the pages in the patient‟s file. Items are effectively the writing on each page. These are displayed in the Item

Panel on your screen. Once again, only the items that belong to the currently selected transaction will be displayed.

Normal Items

In the Introduction session Items were described as being containers and this is evident when you look at some of John Test‟s transactions:

1) Select the

General Practice

transaction that occurred on the 19 th

of

January 1994.

2) Observe the item

liver

function tests:

. This item

contains

the result

normal

.

3) Normally, you can open the container by clicking on it once to select it and pressing the

Return

key. Alternatively you can click on it twice with the mouse. Try it.

If you have permission to edit this item it will open

– otherwise a warning box appears!

4) Click on

OK

to close the Item window or warning box.

Aggregate Items

These are items that have more than one container. To see an example of these :

5) Select the

consultation

transaction that occurred on the 23rd of

February 1997.

6) Observe the aggregate item

blood pressure:

. This item

contains

multiple results,

systolic blood

,

diastolic blood

.

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Adjusting the Item Panel Display

Notice that the Item Panel also has Column Adjuster bars :

1) Point your mouse at the item column adjuster bars and drag to resize.

Item information is hidden when the column width is made too small.

2) Drag the item column adjuster bars back to approximately where they were.

That concludes our look at the HCR window. Lastly we will look at the last line of the screen. This is part of the HEALTH

one

TM screen and contains the Prompt Area

– you have observed this earlier – and the

Session Information Area.

Session Information Area

This area of the screen displays information about the current source reminds you how you logged on :

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Closing a Patients File

To close a patient‟s file you select CLOSE HCR from the File Menu. If you had made any changes that had not been saved HEALTH

one

TM would prompt you to do so now.

We have not, or least should not have, made any changes to his file.

Select

CloseHCR

from the File Menu

John Test‟s file is closed.

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To close the HEALTH

one

TM

program you simply select Exit from the File

Menu.

1) Select

Exit

on the File menu

Close dialogue box appears.

2) Click on the

Yes

button or simply press the

RETURN

key.

HEALTH

one ™

program closes and you are returned to the desktop.

Summary Guide

Start HEALTH

one

Double click this icon on your desktop : or select the menu sequence :

Start

/

Programs

/ HEALTH

one

TM

/ HEALTH

one

TM

for

Windows

Open the patient selector window Click on the „open‟ button on the

HEALTH

one

TM

Toolbar and select HCR. Note : The patient selector is normally open at all times.

Select a patient in the patient selector window Click once on the filter above the column to be searched to activate it. Type the text to be matched Click twice quickly on the name of the patient in the patient list.

To add/remove a column to/from the patient selector Click once on the

Configure

button at the bottom of the selector window. Click on the column select box required to add/remove the tick mark.

To sort the patient selector window Click on the column heading to be sorted

– ascending sort will occur. Click again for descending sort. Click again to cancel sorting.

To adjust the patient selector column widths Place the mouse cursor on the column adjuster bar required and drag to adjust.

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To minimise / maximise patient HCR display Use the left most button of the HCR window controls to minimise the display and the centre button to maximise.

To select a menu option Point to the menu required, click once, point to the menu option, click once again

To quickly navigate through transactions in a patients file.

Select any transaction in the Transaction Panel. Now use these short cut keys :

To go to the first Admin page

Ctrl + Home

To go to the Last Transaction

Ctrl + End

To change chapters

Ctrl + Page Up

,

Ctrl + Page Down

To go to the next transaction

Ctrl + Down Arrow

To go to the previous transaction

Ctrl + Up Arrow

To go to the first transaction in a chapter

Ctrl + B

To select which information is displayed in the transaction panel

Right click anywhere in the transaction panel; select the filters option then select the display option required.

To display only those transactions relating to a problem

In the Problem Panel select the problem to be filtered on.

Click anywhere in the Transaction Panel to activate it and press

Ctrl + E

To adjust the width of the Transaction Panel Drag the panel width adjuster bar.

To view the attributes of a transaction Select the transaction required.

Now click on the transaction Attributes button on the Transaction Panel toolbar.

To close a patients file Select the menu option

File

/

Close HCR

To close HEALTH

one ™

Select the menu option

File

/

Exit

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Own Notes

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Transactions & Items

In this session we apply some of the techniques learnt so far. Our patient, John Test, has visited the surgery complaining of a painful lump on his neck.

We assume that he is the first patient of the day and you have not yet started the HEALTH

one ™

program.

Starting the Program and Logging In

Start the HEALTH

one ™

program and login.

HEALTH

one ™

opens and the Patient selector window appears.

If you are unsure about starting HEALTH

one ™

and logging in refer back to the beginning of the previous session.

Opening John Test’s Health Care Record

We practised this in the previous session:

1) If the Surname filter is not currently selected (cursor flashing) click

 once in the white box above the

Surname

column heading.

Surname filter is now selected

2) Type

Te

The list of patients reduces to display only those whose surname begins with „Te‟‟

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3) Select

John Test

in the patient list.

4) Click on the

Select

button.

The Health Care Record (HCR) for John Test opens.

Creating a New Transaction

To record the visit of John Test we need to add a page to the medical chapter of his HCR. To do this we simply create a new Medical Chapter

Transaction. The new transaction will be added to the end of his file.

1) Click once on the

Create Medical Transaction

button on the Transaction Panel Toolbar. (See reference sheet).

The Transaction Properties dialogue box appears

– see Fig.3.1

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Transaction Attributes

In the previous session we mentioned that each transaction has a set of attributes. Some of those are specified at creation time in the

Transaction Properties dialogue box above.

Responsible:

Specifies the name of the person responsible for creating or maintaining this transaction. This list shows the name of the person logged on and the names of any other people that have delegated their right to create transactions to the logged on user.

Note: There is also an attribute called Author (not displayed on the

Transaction Properties dialogue box) which is automatically set to be the name of the person who validates the transaction

– see

Transaction Status later in this session.

Date of event:

Automatically set to the current date and time. Note: You can change this if, for example, you are updating a patient‟s HCR at a later point in time.

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Speciality:

This is another drop down list that specifies the medical speciality being recorded. In general practice this is useful when a consultants report pertaining to a speciality is being recorded, or, for example, a patient is being admitted to hospital. In most cases the speciality would be „General Practice‟.

Legal Structure:

HEALTH

one ™

can define a person as performing one or more roles in a practice. If this were the case you would select the current role here. Usually, a person only performs one role, i.e.

Physician, and this box can be ignored.

Comment: This new box gives the user additional flexibility in tagging transactions. You can insert any free text you like here.

Alternatively you can use an associated list of preferred terms that can be defines using the configuration tool.

Problem:

The concept of problems was mentioned in the previous session. This is where a transaction is declared as being related to an existing problem.

Note:

This can be completed later when the reason for the visit is known.

2) Complete the Transaction Properties dialogue box by observing the lists for the attributes and then setting their values as follows:

Type

Contact

Name

Responsible

Date of event

Speciality

Consultation

Your name

Current date and time general practice

Legal Structure

Physician/general practice

Problem

None

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3) Click on the

OK

button.

New transaction is completed and appears at the end of John

Test‟s medical chapter. See Fig.3.2. It is printed in Bold and

Italic (see the Transaction Status information box below)

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Shortcut to Creating a New Transaction

It is possible to create new transactions directly from the patient selector.

Below is a screen shot of the patient selector:

Shortcut to Creating a New Transaction

The three consultation types available are the first three transaction names that have been defined in the configuration tool. You can change the consultation types, and the icons associated with each, by opening the configuration tool.

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The first three consultation types in the list are those available in the patient selector of HEALTH

one ™

. You can move a name on this list up or down by clicking on the name and dragging it to your preferred position in the list.

The Item Selector

HEALTH

one ™

items are accessed via the Item Selector window

–this displays a dictionary of all the items in HEALTH

one ™

.

Clicking on the Item Selector Button on the Item Panel Toolbar, illustrated below, will display the selector window (see fig 3.3).

Item selector

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Inserting Items

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1) Ensure that the newly created transaction is selected in the

Transaction Panel and then click once on the Item Selector Button.

Item Selector dialogue box appears.

2) Click on the

Sorted

option.

Tick (called a Check Mark) appears in the Sorted option check box and the list is sorted into alphanumeric order.

3) Uncheck the

Sorted

option by clicking on it once again.

4) If the

Synchronous

option is unchecked

– check it now by clicking on it.

5) If the

Leading

option is unchecked

–check it now. Type:

as

Only Items that begin with „as‟ are displayed

6) Uncheck the

Leading

option.

All Items that contain the letters „as‟ together anywhere in their name are displayed.

7) Delete the as in the Find box.

Full list of items appears once more

8) Uncheck the Synchronous option.

Refresh button activates

9) Type in capitals: IC

Nothing happens

10) Click once on the Refresh button.

All Items that contain the letters „IC‟ together anywhere in their name are displayed.

11) Check the Synchronous option.

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Refresh Button de-activates

– screen stays the same because

Synchronous is active and filtering on „IC‟.

12) Check the Match Case option.

Only Items that have upper case (capital) IC anywhere in their name are displayed.

13) Uncheck the

Match Case

option.

Now we will locate the first item needed to record this visit of John Test.

Firstly, set the Item Selector options as follows:

Match Case

Leading

Sorted

Synchronous

= Unchecked.

= Checked

= Unchecked

= Checked.

We need to locate the Item:

subjective symptoms

1) Delete the

IC

in the Find box and type su



All items beginning with „su‟ are now displayed.

2) The Item subjective symptoms should already be selected, if not, select it now by clicking on it once.

3) Click on the

OK

button

The Item Selector box closes and the Item „subjective symptoms‟ is added to the transaction detail panel and its associated list appears.

We will look at the Associated List in more detail later. To continue:

4) Click once on the Associated List

Close

button.

Associated List box closes and Subjective Symptoms dialogue box is active.

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Showing/Hiding the Item Attributes Panel

1) To show or hide the Item Attributes panel click on the illustrated

 button once. Click again to close.

The Item box should now appear as in Fig.3.4

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Typing and Editing Text

Typing and editing follows the usual text editing techniques:

1) Type the following:

This is a line of text typed by

your

name

2) Press the Backspace key repeatedly to delete your name and the text

„typed by‟

Text now reads „This is a line of text‟

3) Use the Left Cursor key to move the flashing insert cursor to before the l of line. Type: new

Text now reads „This is a new line of text‟

4) Drag across the words a new to select them and type: an old

Text now reads „This is an old line of text.

5) Drag and select the entire line of text. Press the Backspace key.

Text deleted.

The Item Dialogue Box

Term Lists

HEALTH

one

TM

is designed to keep the amount of typing necessary to maintain a patient‟s record to a minimum. This is achieved by selecting

terms

from various sources and supplementing these with typing if necessary. The three most common sources of terms are:

The Term Dictionary

A complete list of terms known to HEALTH

one

TM

The Associated List

A list of terms related to the current Item.

The Permanent List

A list not related to a specific item that expresses degree, intensity, size etc as opposed to a particular complaint.

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To display a list you click on its illustrated button on the Item dialogue box toolbar.

There are a number of good reasons to use lists as opposed to typing:

Firstly It saves you time because it is quicker to choose a response from a list than type it yourself.

Secondly I t‟s easier, there is no need to remember the spelling of complicated medical terminology.

Thirdly It is more consistent, you are more likely to express a condition in a similar manner using terms from a list as opposed to typing a response. This can become very important when analysing your patients later and locating occurrences of a particular illness or condition.

Using the lists takes a little effort at the beginning but very quickly becomes far more efficient than typing. In short, we encourage you to use the lists wherever possible.

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The Term Dictionary

OK, now to continue with John Test:

1) Click once on the Term Dictionary Button

Term Selector Window appears

2) Ensure that only the Leading and Synchronous options are checked.

3) Type: nec

List reduces to only terms beginning with „nec‟

4) Select the term: neck pain

5) Click on the OK button.

„Neck pain‟ inserted as a response and the selector window closes.

The Permanent List

John Test describes the pain as acute. To record this we use the

Permanent List:

1) Click once on the Permanent List Button.

Permanent List appears.

2) Select the term: acute, press the RETURN key

Acute sub-list appears

3) Ensure that acute is still selected and click on the Insert button.

Item response now reads „neck pain acute‟

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Selecting / Deleting a Term

A term selected from one of the lists is treated by HEALTH

one

TM

as a complete unit, i.e. the term

acute

can only be deleted entirely not as individual letters

a c u t e

.

1) Press the Backspace key until the term acute is deleted

The ENTIRE term „acute‟ is deleted.

2) Click once anywhere in the neck pain

The entire phrase „neck pain‟ becomes highlighted to indicate that it is selected

To cancel a selection:

3) Press the Right Cursor key to move the Insert Cursor away from the selected term.

„neck pain‟ is no longer selected.

Associated Lists

Many Items have a list of common terms associated with them which is displayed in the Associated List Selector dialogue box.

1) Click once on the Associated List Button.

Associated List dialogue box appears.

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List Options

These are identical in meaning to the Item Selector dialogue box and the only new objects are the List Type selector and History Box. The list type selector provides an alternative way to display the Permanent

List we used a moment ago.

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Associated Lists

The History Option Box

To use the History box you need to understand how the list is structured.

List Structure

This particular item,

subjective symptoms

, has terms associated with it which themselves have a list associated with them. You will know when a term has a list of its own because the icon illustrated will appear to the left of it.

As an example, take the term „common‟ and the further selection of one its terms „sore throat‟.

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The History Box notation displays the name and level of the current list being viewed. The more sub-lists you select the higher the level number will become. In addition the History Box can be used to move easily to a different level by clicking on the down arrow to its right and selecting the level required.

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Navigating the List:

1) Click once on the term: common to select it and then press the Right

Cursor Key once.

Sub-

List for „common‟ term appears and History Box displays

„0:common‟

2) Use the Down Cursor key to select the term sore throat, now press the

Right Cursor key once again.

Sub-

List for „sore throat‟ term appears and History Box displays

„1:sore throat‟

3) Press the Left Cursor key once to return to the list 0:common.

Associated Lists

4) Press the Left Cursor key again to return to the full list of associated terms.

5) Spend a little time experimenting with the Up, Down, Left and Right cursor keys to see their effect.

6) Click once on the Close button

Associated List dialogue box closes

7) Click once again on the Associated List Button to re-open the dialogue box.

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Using a Term as a Response

The cursor keys are used to navigate the various terms and lists, however, to use a term as a response simply select it press the RETURN key. If the term has a sub-list this will be displayed as well as the selected term being placed into the Item dialogue box. If the selected term does not have a sub-list pressing the RETURN key will use the term as a response and the Associated List dialogue box will automatically close.

1) Ensure that the term common is still selected, press the Right Cursor

Key once to display the sub list.

2) Use the Down Cursor key to select the term lump, and press the

Return key.

The Item dialogue box now reads „neck pain lump‟ and the associated list box has closed.

3) Click the OK Button.

Item dialogue box closes and the Transaction Detail Panel appears as shown:

Note : If you do not wish to use Associated lists it is possible to disable them. To do this click on the menu item « tools

– options ».

They can be restored at any time.

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Automatic Item Selector Display

The Subjective Symptom Item is now complete. Next, we will record the

Objective Findings.

To place another Item into this transaction for John Test we would normally click on the Item Selector Button on the Item Panel Toolbar, however, HEALTH

one

TM will automatically assume you are searching for an item as soon as you type! It will also display the dialogue box with the list filtered on what was typed.

1) Type an: o

The Item Selector dialogue box appears with the items beginning with „o‟ already displayed.

When you are familiar with HEALTH

one

TM

you will realise that this is an advantage because it saves you time, however, at first it can be confusing.

2) Click once on the Cancel button. The Item Selector dialogue box closes.

More Items

Inserting the Objective Findings Item

1) Click once on the

Item Selector Button

on the Item Panel Toolbar.

2) Type: ob in the Find Box

Item list reduces to those beg inning with „ob‟

3) Ensure that the Item objective findings is selected and click once on the OK button.

The Item „objective findings‟ is placed into the transaction detail panel and its associated list box opens automatically.

The term we require is not in the Associated List but in the Term

Dictionary:

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4) Click on the Close button to close the Associated List dialogue box. (or press „Esc‟).

5) Click once on the Term Dictionary Button.

Term dictionary now appears

6) Type:

seb

in the Find box and select the term

sebaceous cyst

, click on

OK

Term „sebaceous cyst‟ entered as a response and the dictionary closes.

We will now supplement this term with additional text:

7) Type:

2 x 2 cm

Response now reads „sebaceous cyst 2 x 2 cm‟

8) Click on the

OK

Button to complete this Item.

Transaction detail Panel now has two items entered.

Inserting the Assessment Item

1) Click once on the Item Selector Button on the Item Panel Toolbar.

2) Type: as in the Find Box

Item list reduces to those beginning with „as‟

3) Ensure that the Item assessment is selected and click once on the

OK button.

The Item „assessment‟ is placed into the transaction detail.

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The Assessment Item does not have an associated list.

4) Use the Item Dictionary to enter the term sebaceous cyst as a response.

5) Type: back of

6) Use the Item Dictionary to enter the term neck as a response.

Response now reads „ sebaceous cyst back of neck‟

7) Click once on the OK button.

More Items

The Assessment Item is now completed and your screen should appear as in Fig.3.5 below:

Lastly, we will complete this session by inserting the Plan of Action Item:

Inserting the Plan of Action Item

1) Click once on the

Item Selector Button

on the Item Panel Toolbar.

2) Type:

pl

in the Find Box

Item list reduces to those beginning with „pl‟

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3) Select the Item

plan of action

and click once on the

OK

button.

The Item „plan of action‟ is placed into the transaction detail panel and its associated list box opens automatically.

Skipping a Term as a Response

This time we wish to use a term from a sub-list but omit the term the list belongs to:

4) In the Find Box type:

pr

. Ensure the term

procedure

is selected and press the

Right Cursor

key once.

The sublist for „procedure‟ is displayed but the term is not placed in the Item dialogue as a response.

5) In the Find Box type:

ex

, and ensure that the term

excision

is selected. Press the

Return

key.

The sublist term „excision‟ appears as a response and the associated list box closes.

6) Type:

shelled out successfully

Click on the

OK

button.

Inserting a Repeat Item

Sometimes, for presentation purposes or because there is a great deal of typing required as a response or because there is more than one condition to be recorded, it may be necessary to use more that one item of the same name. You can use as many items of the same name as you require in a transaction. HEALTH

one

TM has a quick procedure to do this; simply select the item to be repeated and type an

=

.

1) Ensure that the newly created

plan of action:

item is selected in the transaction detail panel. Press:

=

(

equals key

)

A new „plan of action‟ item is created and its associated list appears.

2) The first term

follow up

is the one we require. Press the

Return

key.

The term „follow up‟ is used as a response and its sub list appears.

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Inserting a Repeat Item

3) Select the term

1 week

in the sub-list and press

Return

.

4) Click

OK

to close the plan of action dialogue box.

Your completed transaction should now appear as in Fig. 3.6.

Saving a Patients File

Whenever you have created a new transaction or made changes to a patients file you should save the file. HEALTH

one

TM

transactions can be

Saved or Validated or Saved and Validated at the same time.

A Saved transaction is one that has been written to the patients file and will be available the next time the file is opened, however; it will not become part of the HEALTH

one

TM audit trail until it has been validated.

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To save a patients file you select Save from the File Menu.

1) Select

Save

from the File Menu

-

Validation prompt appears.

2) Click the

Validate

Button.

3) Select

Close HCR

from the File menu.

File closes and the Patient Selector window is once more in view.

Note: By option you can skip the confirmation dialogue when saving a transaction

– the transaction will be validated automatically. To do this click on the menu item « tools

– options » and tick the option «CTRL+S validates transactions without confirmation». Then press CTRL+S to save and validate when in a patients file.

Closing the

HEALTH

one

TM

Program

To close the HEALTH

one

TM program you simply select Exit from the File

Menu.

1) Select

Exit

on the File menu

Close dialogue box appears.

2) Click on the

Yes

button or simply press the

RETURN

key.

HEALTH

one

program closes and you are returned to the desktop.

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Summary Guide

Create a new Medical Transaction

Click on the New Medical Transaction button on the TRANSACTION

PANEL Toolbar. Complete the transaction properties box.

Insert a new Item

If you know the name of the item you require simply type its name when the transaction detail panel is active. Otherwise, click on the Item

Selector button on the ITEM PANEL Toolbar and select the required item from the list.

Display / Change the attributes of an item.

First ensure that the item is open for editing by selecting it and pressing the RETURN key. Now click on the attributes panel button to display these. Click once again on the same button to hide these.

To display the term dictionary when editing an item.

Click once on the blue book on the item dialogue box toolbar or type

Ctrl + T

To re-display the associated list when editing an item

If an item has an associated list it will automatically open when the item is opened for editing. To re-display it once closed click once on the associated list button on the item dialogue box toolbar or type

Ctrl + A

To display the permanent dictionary when editing an item.

Click once on the permanent list button on the item dialogue box toolbar or type

Ctrl + P

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To navigate an associated list

If the term required has no sub list of its own simply press RETURN to include it as a response. If the term has a sub list of its own, you can:

Press

RETURN

– include term and display sub list.

Press right arrow to exclude term and display sub list.

Click on the term with the

Right

mouse key to display a menu. Now click on SELECT to include the term without displaying the sub list.

Press left arrow to return to the term from a sub list.

Repeat an Item

Select it and press the equals key.

Save a patients file

Select the menu sequence

File

/

Save

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Own Notes

HERE

– a new patient on

PDF

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Creating A New Patient Health Care Record

In this session all the techniques needed to create a file for a new patient will be discussed.

We assume that you have not yet started HEALTH

one

TM for this session, if you have go straight onto

Creating A New Health Care Record

below.

Starting the Program and Logging In

Start the HEALTH

one

TM

program and login.

HEALTH

one

TM

opens and the Patient selector window appears.

If you are unsure about starting HEALTH

one

TM

and logging in refer back to the beginning of the

Getting Around

session.

Creating a new Health Care Record

This can be done directly from the Patient Selector Window:

1) Click once on the

New

icon at the bottom of the window.

You are about to create the first transaction in this patient‟s file, this is always the “Patient Identification” transaction.

New Patient HCR created and the Patient Identification Items, surname:, first name:, sex: and date of birth: automatically appear in the Item Panel.

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Figure 1

Minimum Administration Items

The patient attributes list appears in the first transaction of the administration section.

The four items

surname:

,

first name:

,

sex:

and

date of birth:

are the minimum needed to create a new patient file.

1.

Ensure that the

surname:

item is highlighted. Press the

Return

key.

The „surname:‟ item opens ready for editing.

2.

Type:

Tennant;

Press the

Return

key.

The „surname:‟ item only requires a single line of text and automatically closes when the RETURN key is pressed.

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The highlight automatically moves on to the next item in the list.

3.

Press

Return

to open the

first name:

item. Type:

Sarah

Press the

Return

key.

4.

Press

Return

again to open the

sex:

item.

Restricted Response List

The possible responses to the

sex:

item are limited. For items like this

HEALTH

one

TM

will often present a list of possible terms. To complete this item, you can:

Use the cursor keys.

Type the first letter of the response, i.e. M male or F female

Click on the down arrow to the right of the response box to display the list and select you answer by clicking on it with the mouse.

Experiment with all of the above techniques. Select the response female. Press

Return

the

„sex:‟ item closes and highlight moves onto the next item. Press

Return

. Type carefully:

12071972

for the date of birth.

5.

Press the

Backspace

key ( ) to delete the

2

of

1972

and type a

0

Press

Return

to complete the item.

The minimum items are now completed. See (fig.2)

Date Problem ?

See the information box on the next page

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Creating a new Health Care Record

6.

Enter in any other attributes required for the patient. They can be entered at a later stage

.

Saving the new Health Care Record

1)

Click on the „Save‟ button on the HEALTH

one

TM

Toolbar at the top of the screen,

Dialogue box appears:

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Select

Save

.

The new patient file has been saved to disk and remains open for further editing if required.

Notice that the HEALTH

one

TM

information

Bar now displays Sarah‟s

Name, Date of Birth, Sex and Age.

Closing the Health Care Record

Select

Close HCR

on the File Menu.

Sarah‟s file now closes

Exiting

HEALTH

one

TM

Select

Exit

on the File Menu. Answer

Yes

when prompted.

HEALTH

one

TM

closes and the desktop reappears.

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Summary Guide

1.

Create a new patient HCR in the patient selector window When the patient selector window is open click on the

NEW

button.

2.

Create a new patient from the main menu. Select the menu sequence:

File

/

New

/

HCR

or click on the NEW button on the

HEALTH

one

TM toolbar and select HCR or press:

Ctrl + N

3.

Save a patient file Select menu sequence:

File

/

Save

or click on the SAVE tool on the HEALTH

one

TM toolbar or press:

Ctrl + S

4.

To delete an item -Select the item to be deleted and press the

DEL key. Answer YES when prompted.

5.

To delete a transaction - If the transaction has not been validated simply select it and press the DEL key. Answer YES when prompted. If the transaction has been validated the technique is the same except the transaction will be

marked

as deleted and hidden within transaction list but NOT physically removed from the patient‟s file.

6.

To delete a patient‟s file Open the patient selector window and select the patient concerned. Now click on the DELETE button.

Answer YES when prompted.

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Own Notes

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Adding Basic Medical Information

The Basic Medical Information is a transaction that records data such as allergies, past medical and surgical history, etc. It effectively acts like a summary chart in your manual notes. This is usually the first page in the

Medical Chapter and has a unique icon to represent it. Illustrated on the left,

Starting the Program

1) Start HEALTH

one

TM and Login.

Patient selector window is now open.

Opening a Health Care Record

To open an existing patients HCR:

2) Type:

Te

in the surname filter

3) Select

Sarah Tennant

in the patient list.

4) Click on the

Select

button.

The Health Care Record for Sarah Tennant opens.

Creating a new Basic Information Transaction

We are now going to record the Basic Medical Information in Sarah

Tennant‟s HCR.

Use the icon to quickly create a basic medical transaction

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Figure 1.

As you can see from figure 1 above the basic medical information sequence is added, next we select the sequence items we require.

Managing Items

In this instance we are going to skip over the first item because we wish to leave it in the file merely as a descriptive title.

1) Ensure the

basic medical information

Item is selected. Press the

Down Cursor

key once.

„medical history:‟ item is now highlighted

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2) Press the

Return

key to edit the

medical history:

item. In the associated list

Find

box type:

h

 only terms beginning with „h‟ remain in the list.

Quick Clicks

3) Select the term

hypertension

in the list by clicking on it twice

 quickly (keep the mouse perfectly still between clicks).

„hypertension‟ added to the medical history item.

4) Click

OK

to close the medical history: item.

Repeating an Item

We wish to record more medical history information for Sarah and to do this another medical history item is required. There is a quick way to do this if an item of the same type already exists in the transaction you are editing. Simply select (not edit) the item which is the same type and press the (=) equals key.

5) The highlight is now on the

surgical history:

item. Press the

Up

Cursor

key once to re-select the

medical history:

item ( or simply click on it once with your mouse)

„medical history:‟ item now highlighted once more.

6) Press the equals key

=

once

A new „medical history:‟ item is inserted and opens for editing.

7) Double Click on

pneumonia

in the associated term list.

„pneumonia‟ added as a response for this item.

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8) Do not close this item yet

Managing Items

Setting Item Attributes

Each item has a series of settings called attributes, which are in addition to any contents that may have been entered. These perform various functions including how the item and its contents appear on screen, how severe the condition being recorded is

– via a gravity index, moment of occurrence, person responsible and various other information. These are displayed by clicking on the button illustrated when the item is open for editing.

1) The medical history item that contains the term

pneumonia

should

 still be open. If not, open it now for editing and close the associated list box when it appears by clicking on its

Close

button.

„pneumonia‟ text displayed.

2) Click once on the button to display the items attributes.

3) Set the attributes the same way as illustrated in Fig.3:

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Fig.3 Medical History Item Attributes

4) When completed click on the

OK

button.

Item closes and appears in red.

Setting Item Display Mode

You may have noticed in Fig. 3 the

Display Mode

box

– which we left on its default setting of

Normal

. Normal display mode shows the Item

Name followed by its contents. There are several other ways to display item information

– you can select these by either right clicking with your mouse on the item and selecting

Display Mode

, then select the mode required from the menu, or, click once on the item to select it and then use the short cut keys.

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Managing Items

Setting Item Display Mode

1) Right Click with the mouse on the

medical history:

item for

pneumonia

just created

.

Menu appears

Select the

Display Mode

option

– then select the

Right

option from the next menu.

The item contents „pneumonia‟ stays in view but the item name „medical history‟ has disappeared.

3) Experiment with other display settings for the same item.

4) Ensure that the item is still selected and press

Ctrl + 3

Item display returns to „Right‟ mode.

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Managing Items

Viewing Item Attributes

You do not need to open an item for editing to view its attributes. This is only necessary if you wish to

change

their settings. To view, simply select the item by clicking on it once with the mouse and then click on the

Attributes

button on the Item Panel Toolbar

– illustrated on the left.

1) Click once on the

pneumonia

medical history: item to select it.

Click once on the Item Panel Toolbar

Attributes

button.

Attributes for the selected item appear.

2) Close the Attributes window by clicking once on the button.

Windows closes

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Completing the Basic Medical Information

Surgical History:

3) Open the

Surgical history:

item for editing. Select

appendicectomy

from the associated list. Do not close the item yet.

4) Set the

Date of Event

attribute to:

01/07/1992

5) Click on

OK

to close the item.

Family History:

6) There is a history of Heart Disease in the family. Open the

family history:

item and record this by selecting the appropriate term from the associated list and close the item.

Completing the Basic Medical Information

Tobacco:

7) Open the

tobacco:

item for editing. Select

cigarettes

from the associated list. Then type:

20 p/day

.

8) Click on

OK

to close the item.

Alcohol Consumption:

9) Open the

alcohol consumption:

item for editing. Select

social

from the associated list. Then type:

8 units/week

.

10) Click on

OK

to close the item.

Blood Group:

11) Open the

blood group:

item for editing. Select

A neg

from the associated list.

12) Click on

OK

to close the item.

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Recording & Displaying a Problem

Sarah has hypertension and it would be nice to see this instantly when the patient file is opened

– to facilitate this we use the Problem

Panel. HEALTH

one

TM copies the contents of the item(s)

problem:

and places it into the Active window of the Problem Panel. Each problem is assigned a START date and - when inactive - an END date. Items that have been given an end date are moved from the Active to Inactive window of the Problem Panel.

1) Ensure the Item

problem:

is highlighted. Press

Return

to open.

2) Close the associated list and click once on the Term Dictionary (Blue

Book)

Term Dictionary window appears.

3) Type:

Hypert

and then select the term

Hypertension

in the list. Click

OK

The term „Hypertension‟ is now in the Problem dialogue box.

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4) If the Item attributes are not on view click once on the button to reveal them.

5) Click on the START date to activate it and type:

28091978.

Now click

 on

OK

to close the problem item window.

The problem item closes but the contents „Hypertension‟ does not appear in the Problem Panel

– it must first be validated.

6) Click once on the

Save

button on the Standard Tool Bar and select

Yes

when prompted to validate the transaction.

„Hypertension Now Appears in the active Problem Panel.

Recording Non Medication Related Allergies

To record allergies which are not related to medication, such as Gluten,

Cat Hair etc. we use the item allergies

:

Allergic reactions to medication are recorded by using the Drug Module. The technique is fully described in the

Prescription Manager

chapter.

Inserting a new Item

1) Ensure that the item

problem:

is still selected. Now click once on the

Item Selector

button on the Item Panel Toolbar.

Item selector window opens

2) In the Find box type:

all

All items names beginning with „all‟ are listed.

3) Select the Item

allergies:

in the list. Click

OK

Item „allergies:‟ is inserted and automatically opens the associated list‟

4) Select

cat hair

from the associated list

5) Click on

OK

to close the item.

6) Ensure the

allergies:

item is still highlighted and press the equals key = once

New „allergies:‟ item created.

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7) Select

dog hair

from the associated list.

8) Set the

Display mode

attribute to:

Content Right

9) Click on

OK

to close the item.

10) Ensure the new

allergies:

item is still highlighted and press the equals key

=

once more.

A third „allergies:‟ item created.

Recording Non Medication Related Allergies

Using the Term Dictionary

The Term Dictionary was mentioned in session three. We use it whenever the associated list does not have the term we require. Sarah has a gluten allergy. Gluten is not included in the allergy associated list.

11) Close the associated list box.

12) Click once on the

Term Dictionary Button

(blue book)

Term Dictionary windows opens.

13) Type:

glut

in the

Find

box. Select the term

gluten

in the list and

 then click on the

OK

button.

„Gluten‟ term is inserted as a response.

14) Set the

Display mode

attribute to:

Content Right

That completes the Sarah‟s medical information.

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Saving a Patient File

Select

Save

on the File Menu and select

Yes

when prompted to validate the transaction.

Select

Close HCR

from the File Menu.

Sarah‟s file closes and the patient selector window reappears.

Quitting

HEALTH

one

TM

Select

Exit

on the File Menu. Answer

Yes

when prompted.

HEALTH

one

TM

closes and the desktop reappears.

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Summary Guide

To repeat an item - Select the item to be repeated and press the equals

=

key.

To set item attributes - First ensure that the item is open for editing by selecting it and pressing the RETURN key. Now click on the attributes panel button to display these. Click once again on the same button to hide these.

To change the item display mode - Right click on the item to be changed and select the option

Display Mode

from the menu. Now select the display mode required from the submenu‟

To view the attributes on an item

-

Select the item required and click once on the attributes button on the HCR Toolbar.

To use a term from the Term Dictionary as a response to an item.

Click once on the blue book on the item dialogue box toolbar or type

Ctrl + T

. Now select the term required in the list.

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Own Notes

Complete to here

– pg 80 on pdf. doc.

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Analysis

Analysing Patient Information

One of the strengths of HEALTH

one

TM

is its ability to analyse patient information. There are two categories of analyses: Individual Patient

 and Population. Below are listed the types of analyses available in each category:

Individual Patient Analyses

Item Analysis o

Active Item in a patient‟s file o

Any Item in a patient‟s file

HCR Analysis -

Multiple items in a patient‟s file.

Prescription Analysis - Drugs prescribed for a patient.

Grid Analysis - Numerical data, table/graphic representation, i.e. audiometry charts, percentile charts etc.

Population Analyses

Template - Produce a document that can be viewed, printed/saved.

Database - Produce results that can be viewed, printed and/or exported.

These analyses all use pre-set analysis definitions. It is also possible for you to create your own definitions to add to the existing lists, however; it is beyond the scope of this manual to describe how this is done. In this session we will be using the standard definitions as supplied with the product.

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The various analyses are selected via the HEALTH

one

TM

Analysis

Toolbar. In the case of individual patient analysis the patient‟s HCR must be opened before selecting the analysis. Population analysis does not require a patient‟s HCR to be open.

The patient John Test has a very mixed history. Ideal for analysis:

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Getting Started

1) Start HEALTH

one

TM and Login.

Patient selector window is now open.

Opening a Health Care Record

To open an existing patient

‟s HCR:

2) Type:

Te

in the surname filter

3) Select

John Test

in the patient list.

4) Click on the

Select

button.

The Health Care Record for John Test opens.

Item Analysis

Item analysis has two forms, Active Item or Any Item. Each has its own button on the HEALTH

one

TM

Analysis Toolbar.

Active Item Analysis button. Technique: click once on any item you would like analysed. Next, click on the button opposite. An analyse window opens and displays the value of each occurrence in the patients

HCR..

Any Item Analysis button. Technique: click once on the button opposite and select the item to be analysed from the item list. An analysis window opens and displays the value of each occurrence in the patients HCR..

Active Item Analysis

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For this we will use the aggregate item Blood Pressure. This is very handy when you would like to see at a glance previous pressures.

1) Select the consultation of the 24/10/1994 by clicking on it once in the transaction overview panel.

2) In the HCR Transaction Detail panel click once on the bold print item:

blood pressure

3) Now click on the Active Item Analyse Button.

Active Item analysis window opens and shows all blood pressures recorded in the file. Fig 1

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Item Analysis

Active Item Analysis

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4) Experiment with selecting different options in the display filter.

5) Close the analysis window by clicking once on the cross in its top right hand corner.

Any Item Analysis

This analysis does not require the item that is to be analysed to be preselected.

1) Click on the

Any Item AnalyseButton

on the HEALTH

one

TM

AnalysisToolbar.

2) Type:

wei

in the Item find box. Select the item:

weight

.

3) Click

OK

„Item Analysis: weight‟ window opens and displays results.

4) Close the Item Analysis window.

Fig.1 Active Item Analysis Window

Aggregate Item Blood Pressure Analysed

Display

Filter

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HCR Analysis

This is a more complex analysis of the Health Care

Record. Clicking on the

HCR Analysis button, illustrated opposite will cause a list to be displayed.

This list contains pre-set analysis definitions. Select the one you require and then click on the

Execute

button. The result is displayed in an analysis window

1) Click on the

HCR Analysis

Button.

2) Select

Liver Profile

from the list.

3) Click on the

Execute

button.

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Liver function analysis is performed and displayed in a HCR

Analysis window.

Some of the HCR analysis definitions prompt you for a response, i.e. for a start/end date.

4) Close the HCR Analysis window and then click on the

HCR

Analysis

button once again.

5) This time select the

Between date x and date y

analysis. Click on the

Execute

button.

The analysis runs and prompts for a start date.

6) Enter

01101997

as a start date. Click on the

TICK

to incorporate the date into the analysis scenario.

The analysis now prompts for an end date.

7) Enter

01101998

and once again click on the

TICK

. The

OK

button should now be active. Click on the

OK

button.

Detail of items between the specified dates are displayed.

8) Close the Analysis Window.

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Prescription Analysis

Like the HCR Analysis in the previous example, the

Prescription Analysis also uses pre-set analysis definitions. Clicking on the

Prescription Analysis button, illustrated opposite, will cause

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Execute

button.

The result is displayed in an analysis window

1) Click on the Drug

Analysis Button.

2) Select

Active therapy

from the list.

3) Click on the

Execute

button.

Active therapy analysis is performed and displayed in a

Prescription Analysis window.

4) Close the Analysis Window. Select

File

/

Close

to close John Test‟s file.

Population Analysis

The population analysis also uses pre-set analysis definitions. There are two different categories: Template and Database.

The

Template

analysis examines every patient‟s HCR, and as a consequence may take time to complete dependant upon the size of your practice. The

Database

analyses are much faster because they use a different method to access the patient data.

The population analysis window is displayed by clicking on the population button illustrated opposite. Unlike the other analyses, population analysis does not require a patient‟s file to be open.

HEALTH

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Display all the patient data in chronological order

This is an extremely useful new function in HEALTH

one

TM

version 5.0.

It allows you to view all of the patient‟s file in one « page » that you can scroll through.

You can easily search all the data for any text you like.

You can access this feature by clicking on the icon « display all data in chronological order » which is on the main HEALTH

one

TM

toolbar :

When you click on this icon you are presented with the following screen :

You can now search all the data in the patient record simply by typing some text in the search box :

You will see all the instances of the searched for text including the dates involved. This can be extremely useful for finding any information you wish in the patient‟s file.

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Population Analysis

Database Analysis (Data Ware House

– DWH – Built in Analysis)

There are a number of pre-set database analysis all of which display their results on screen and many additionally allow the results to be printed as a report.

HEALTH

one

TM

provides an additional tool

– called

Query Tool

which can be used to create your own reports.

Example of Database Analysis with a Screen Display Result Only:

1) Click on the

Population Analysis

Button on the toolbar and then click on the

Database Analyses Tab

2) Double click the

Cube Analysis

entry in the list.

Cube Analysis expands and reveals the „Patients Cube (..‟ analysis.

3) Click on the

PatientsCube (Sex, Age Class, Private/GMS)

analysis to select it and then click on the

EXECUTE

button.

Cube analysis activates and displays the results in a window.

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Population Analysis

Database Analysis cont

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This particular analysis is purely visual and you are not able to produce in report form. Other types of analysis are displayed and can also be reported and/or exported to other products.

Example of Database Analysis with a Screen Display and Report/Export

Options:

We will now close the current analysis and open a new one.

1) Close the current analysis by clicking once on the cross in the top left hand corner of the window.

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2) Double click the

Patients seen

entry in the list.

Patients seen Analysis expands.

3) Click on the

Patientswith an actual encounter between two dates

analysis to select it and then click on the

EXECUTE

button.

Patients seen analysis opens.

This particular analysis requires additional information before it can be executed. You can select patients by a specific date range or by count of last days:

Click on these buttons to extend/collapse an age/sex/class distribution element.

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Population Analysis

Database Analysis ..continued

4) Select the

Last Days

option and enter a value for the

Day count

.

In our example this is

1

This effectively means patients seen today.

5) Now execute the analysis by clicking on the green right facing button on the tool bar. (see illustration).

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6) Experiment with these values and date ranges until you obtain a result. Remember to reselect the execute button to reanalyse each time the values are changed.

Analysis produces a results grid

– sample in fig. 3 below.

Processing The Analysis Results

Once you have produced a result from a database analysis you can:

Simply view it on screen

Produce a report of the results

Export the results to another product

Viewing Results

You can control the grid display in the following ways:

Viewing Results - Maximise The Window

Click on the centre button of the window control in the top left hand corner of the window.

Viewing Results

– Adjust The Width of A Column

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Drag the column adjuster bar on the right of the column title to alter its width.

See fig 3 above.

Viewing Results

– Hide A Column

Drag the column adjuster bar on the right of the column title to the left to hide the column name. See fig 3 above.

Fig 3 Sample result grid of Patient Seen Analysis

Column Width

Adjuster Bars

Row Height Adjuster Bars

Ctrl

+ Drag Column Name to Reposition

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Population Analysis

Database Analysis ..continued

Viewing Results

Viewing Results

– Reposition A Column

Hold down the

Ctrl

key and drag a column by its title area to the left or right to reposition it. See fig 3 above.

Viewing Results

– Adjust The Height of All Rows

Drag any row adjuster bar on the left of the grid to alter the height of all rows.

See fig 3 above.

1) Experiment with the various controls.

Display grid alters.

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Produce a Report Of The Results

To produce a report of the analysis result you simply click on the preview button. Some reports have a pre-set format regardless of the settings of the grid; others will reflect any changes made to the grid.

Once previewed clicking on the print button in the preview window will print the report.

2) Click on the

Preview

button

Report previewed

3) If you wish print the report by clicking on the

Print

button.

Report prints

4) Close the preview window. Close the analysis window. Close the

Population Analysis Window.

Patient selector window should now be back in view.

Exporting The Results

To export the results click on the export button in the analysis window. It will be saved to the location of your choice as a delimited text file.

Adjusting Grid Display

When you have adjusted a grid display to the settings you prefer

HEALTH

one

TM will remember these and the next time the analysis is used it will appear

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Template Analysis: This form of analysis has been superceded by the Built in

Database analysis and the User definable database analysis known as “Query

Plus”. The Query Plus is described in a separate chapter.

Template analyses produce a text report that can be printed and or saved for future reference. This report is displayed in the HEALTH

one

TM

text editor

– which we will learn more about in the next session. There are a number of pre-set analyses in this category and these can be added to by creating your own.

Clicking on the Population Analysis button, illustrated, will cause the analysis list to be displayed. Select the category and analysis you require and then click on the

Execute

button.

1) Click on the

Population Analysis

Button on the toolbar and then click on the

Template Analyses Tab

2) Select

Patients seen on one day

from the list.

3) Click on the

Execute

button.

4) A screen prompts you for the date required. Enter a valid date and click once on the TICK to use it in this analysis.

5) The

OK

button should now be active. Click once on it.

All patients seen on the day specified are listed in a report and displayed in the HEALTH

one

TM

text editor window. Fig.2

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Template Analyses display their results in the Text Editor document window. If you wish to keep the results you can save the document via the menu

File

/

Save

. If the document has not been saved HEALTH

one

TM will prompt you to

Archive

it as an external file or discard it completely when closing the it via the

File

/

Close

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document

menu.

Fig.2 Text Editor Window

Results of Population Analysis Displayed

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Population Analysis

Template Analysis..continued

For now we will close and discard this document.

Select the menu

File / Close document

. Select the discard option as illustrated and click on the

OK

button.

Document is abandoned and the Text Editor closes.

Grid Analysis

This form of analysis is specifically suited (although not exclusive) to analysing and displaying numeric information. The analysis is performed on a patient rather than population basis.

Once extracted the analysed information can be displayed in a table or as a graph. If text items were analysed the result would only be meaningful in a table

Grid analyses are based on one of three sources:

* Predefined Grid Analyses * Any Sequence of Items * Any

Aggregate Item

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When you are more experienced with using HEALTH

one

TM you will be able to create your own Grid Analyses, Sequences of Items and Aggregate Items. For now, we will use those supplied as standard with the product.

In addition there are two predefined analyses:

Growth Analysis

Audiometric Analysis

These each have their own button in the Grid Analysis window (see below) and require no further action other than clicking on them.

Technique

Open the patient file to be analysed

Activate the grid analysis (by clicking on the Grid Analysis

Button on the HCR Analysis Toolbar illustrated opposite)

The Grid Analysis Window opens:

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Grid Analysis

The Grid Analysis Window opens:

Technique ..continued

Select the source required, Grid, Sequence or Aggregate Item by clicking on the Grid Analysis Source Selection Button.

The Grid Selector window opens:

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Growth

Analysis

Chart

Button

Grid Analysis source selection button

Audiometric

Chart

Button

Magnify

View

Button

Filter Button Display Mode Buttons

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Graph or Table

Graph

Type

Buttons

Type here to locate an analysis

Select analysis required here

Select analysis source here

Detail of which items will be analysed displayed here

Click here to restrict the analysis to a date range

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Grid Analysis

 analysis to a date range.

Select the required analysis.

Click on the Select Period box if you wish to restrict the

Click on the as required.

OK

button to activate.

If the Select Period box was selected complete the date range

The results are initially displayed in tabular form in the Grid Analysis window. You can now:

Filter the results

Choose which results are displayed.

Choose how to display the results

– Grid or Table.

John Test‟s HCR should still be open. If you have closed it in the

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Activating the Grid Analysis

1) Click once on the

Grid Analysis

Button on the HCR Toolbar.

Grid Analysis Window opens.

2) Click on the

Grid Source

Selector Button.

Grid Selector Window opens.

3) Ensure that Grid is the selected source.

4) Select

BLOOD PROFILE

as the analysis in the group box.

5) Click on the

Select Period

box to tick it.

6) Click on

OK

to begin the analysis.

Because the Select Period box was checked you are now prompted to enter a date range.

7) There is no need to type the forward slash marks in the date.

Select the

from

date and type

01 01 1994

Select the

to

date and type

31 12 1995

Analysis on John Test blood results appears in tabular form in the Grid Analysis Window. See Fig.4

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Grid Analysis

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Choosing a Table or Graph

This is very straight forward, simply click on the display mode button required.

8) Click on either display modem button to switch between Table and

Graph displays.

9) Select Graph display

Choosing a Graph Type

The choice here is Stacked or Overlapping axis. Selection is via buttons once again:

10) Choose each graph type in turn

11) Reselect the

Table

display once more.

Screen appears once again as in Fig.4 above

Additional Menus

HEALTH

one

TM

now has three additional menus displayed:

Grid Analysis

Grid

Graph

These are an alternative means of selecting the various display options encountered so far, plus a few extra items:.

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Ensure that you are in Table Mode.

Fig. 4 Grid Analysis Window

Results of BLOOD PROFILE Displayed. Figures in brackets are reference range.

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Grid Analysis

The Grid Analysis Menu:

This allows you to quickly select Grid Analysis or the two special analyses Growth and Audiometric and select the display mode required.

1) Experiment with

Grid Analysis / Show /Graph

and

Grid Analysis

/ Show /Grid

menu options

2) Reselect the menu

Grid Analysis / Show /Grid

Table once more in view.

The Grid Menu:

This is applicable when you are in Grid (Table) display mode.

Experiment with the various options on the Grid Menu.

Select the menu option

Grid Analysis / Show /Graph

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Additional Menus

The Graph Menu:

This is applicable when you are in Graph display mode.

Experiment with the various options on the Graph Menu.

Cancel any changes to the customise menu if you have made any.

Printing Grid Analysis

When the Grid Analysis Window is open you can print whatever is displayed by selecting the menu sequence:

7)

File / Print

Closing the Grid Analysis Window

This can be done by clicking on the cross it the top right hand corner of the window or by selecting the menu sequence:

8)

File / Close Grid Analysis.

Finishing This Session

No new transactions have been added to John Test‟s file in this session.

All we need do in to close HEALTH

one

TM

:

Select the menu sequence:

File / Exit

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Closes.

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Summary Guide

To Do Page

To analyse a selected item

Short Cut =

Ctrl

+

I

Open the file of the patient to be analysed.

Select the item to be analysed and click once on the „Analyse Active Item‟ button on the HEALTH

one

TM

Toolbar.

3

To analyse any item

Short Cut =

Ctrl

+

M

Open the file of the patient to be analysed.

Click once on the „Analyse Any Item‟ button on the HEALTH

one

TM

Toolbar. Select the item required to be analysed from the list.

4

To analyse the complete Health Care

Record for a patient.

Open the file of the patient to be analysed.

Click once on the „Analyse HCR‟ button on the HEALTH

one

TM

Toolbar. Select the

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Execute

button.

5

To analyse the drugs prescribed to a patient Open the file of the patient to be analysed.

Click once on the „Analyse Drugs

Prescribed‟ button on the HEALTH

one

TM

Toolbar. Select the analysis required from the list and click the

Execute

button.

6

To analyse the entire patient register.

7

8

Short Cut =

Shift

+

F7

Click once on the Analyse Population‟ button on the HEALTH

one

TM

Toolbar.

Select the analysis type: Template or

Database by clicking on their respective tabs. Now select the analysis required from the list displayed and click the

Execute

button

To create a grid analysis Open the file of the patient to be analysed.

Activate the grid analysis window by clicking on the „Display as Grid‟ button on the

HEALTH

one

TM

Toolbar.

Now, decide on the type of grid analysis required and click on the appropriate button in the grid analysis window:

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Growth Analysis

Audiometric Analysis

Grid Analysis

If you select a grid analysis the grid selector window will open. Now select the grid analysis source:

Grid

Aggregate

Sequence

Select the analysis required from the list.

Click

OK

.

14

To change between grid and graph Select the grid analysis as required. Click on the appropriate button illustrated.

14

To change graph types. Select the grid analysis as required. Click on the appropriate button illustrated.

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Own Notes

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Introduction

The Prescription Manager (PM) is used for the prescribing of two types of prescriptions : repeat prescriptions and acute prescriptions

The first part of this chapter will deal with editing and printing of a simple drug prescription

In the second part, we shall discus the management of the prescription.

We will look at the more complex aspects such as repeat prescription management, the price of the prescriptions and the renewal of prescriptions.

Opening the Prescription Manager

In the majority of cases a prescription will be issued during the course of a consultation.

However, in some cases the prescription may be the only reason for the contact. In either case, it is necessary to create a new HEALTH

one

TM

transaction.

A sequence, for example the medical sequence SOAP. May contain the item « drug prescription » . Never the less, if you create your own transaction, you may directly enter the item « drug prescription »

When a patient file is open and a medical transaction has been created, the prescription

Manager (PM) may be opened in several ways.

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is highlighted, if this item already exists in the transaction.

Press the combination hot keys Alt+F2.

Select the menu « insert » - « prescription ».

Note:

If you open the PM while an existing transaction containing prescribed drugs, is active, the drugs in this transaction will appear in the PM. This is used for editing existing prescriptions or for re-printing a prescription.

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Prescription Module

– Main Screen

The Prescription Manager contains four main panels

1. Drug Selection Panel = Drug list panel

– Top left

2. Allergy/Adverse reaction Panel

– Bottom left

3. Repeat Prescription panel = Repeats panel

– Top right

4. Current Prescription Panel = Active prescription

– bottom right

Drug Selection Panel = Drug List panel.

This panel is used for selection the desired drug. You can choose your drug from a list of brand names or from a list of generic names or from the private database.

You can also choose a drug from any list of drugs already prescribed for this patient as per the screenshot below.

By default, the IPU database containing the entire list of brand names is displayed.

When you type some letters contained in any part of the drug name, the list will be filtered accordingly.

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Selecting a drug from the supplied database :

The contents of the search panel is as below :

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The search zone allows you to see directly the drug as you will prescribe it, including the dosage. The presentation is included in the drug name.

The drug search window also allows you to directly choose a dosage for a drug that may have several dosages predefined by the user. We will see later how to associate dosages with drugs.

Click the button to show the list of predefined dosages. Select the appropriate dosage for this patient.

From the search zone, you can also use the « Ctrl+Up_arrow » or

« Ctrl+Down_Arrow » to switch between dosages.

Selection from generic list :

To select from the generic list, Open the menu and select « Irish

Specialty (IPU

Generic) » or use the Hot keys Ctrl+G

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Drug Name

Pack size

Predefined dosage (if any)

Patient instructions

Pack price

GMS code

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Type in a few letters for the required drug

This list can be made the default view when you open the PM. This will be described later.

Selection of a list from drugs already prescribed to this patient :

Open the menu item below. Select the view you require : Repeat

Prescriptions,

History, Active Therapy or last prescription.

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You can use the following Hot keys to achieve the view you desire : o

CTRL+K for repeats o

CTRL+U for Active Therapy o

CTRL+H for History o

CTRL+L for last prescription

Note:

3.7 users. This view is now available on the left hand panel as well as the top right hand panel as you were used to.

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Repeat Prescription view displays the pack size and the drug name.

The History and last prescription views also contain the date the drug was last prescribed.

For all these views, typing some letters will reduce the list as with the main product filter.

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REPEATS PANEL :

The right hand top panel

– contains the prescriptions from the patient file

(repeats, history, ….)

This panel allow you to view, exactly as in the product search panel, the drugs that are contained in the patient file. These views are optional and were included so that you can see the repeats at all times. This is the default view for Irish users.

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The repeats view contains the following information :

Quantity = number of tablets prescribed for the repeat period

Prescription = name of the drug

Dosage = dose to be taken daily..

Remaining repeats = Total allowed repeats less the number of times prescribed so far (before required review, for example) months 6 months etc

Last prescribed = the date the drug was last repeated

Generic name of the drug

To change the view, simply click on the menu and choose the view you require.

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You may also use the Hot Keys as follows : o

SHIFT+CTRL+K for Repeats o

SHIFT+CTRL+U for Active therapy o

SHIFT+CTRL+H for History o

SHIFT+CTRL+L for the last prescription

Note:

The repeat prescriptions are saved to the Basic medical

Information transaction and are visible at all times from within the patient file from the

« view » tabs

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Allergies and Adverse reaction to Medication Panel:

This panel displays any adverse reactions to medications and allergies :

Normally HEALTH

one

TM stores all drug allergies in the item « Adverse reaction to medication » and stores this item in the basic medical administration transaction.

By convention we use the « allergy » item to store non drug items such as house dust mite etc.

We will describe how to insert adverse reactions later.

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Current Prescription Panel :

This panel displays all the drugs prescribed in this session or, if you open an existing transaction, any drugs prescribed in that transaction.

The toolbar at the top of this screen shows the following :

1. Number of drugs prescribed in this prescription set.

2. The Date of the prescription

3. The total price of all drugs in this set

4. Drug take

– this is the schedule for the patient and can be printed here

5. Next prescription set in the transaction. See later for details of this.

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Prescription Technique

Prescribing and printing an acute Drug

The acute prescription is selected from the standard drug list on the left.

Once selected the drug will appear in the active prescription panel. It is then ready for printing

Technique

– Prescribing Drugs

In this example, we will prescribe a drug from the list of branded drugs.

We can describe prescribing from the other lists later.

Open the patient file and create a new consultation

1) Open the prescription Manager (PM) by hitting the Hot Key combination

ALT+

F2

.

The PM opens. If this doesn‟t happen then use the menu item « Insert

– drug prescription ».

2) Make sure you have selected the « Irish Specialty

– (IPU) from the list in the top left pane.

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1) In the filter box type a few letters : « TENOR »

All the drugs that have the letters TENOR will appear in the list, sorted alphabetically.

2) Press the ENTER key or Ctrl+N to begin a new acute prescription, The drug edit window is displayed.

Drug

Selection

Panel

Active prescription panel

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In this example we will prescribe one tablet once a day for 28 days. The quantity will be calculated automatically, based on the duration.

3) You may also insert patient instructions, which may be printed later.

A detailed description of the drug edit screen follows.

4) Click

OK

.

The drug is prescribed and now visible in the active prescription window.

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2.

5) Repeat the operation for other drugs

6) Click the print icon on the tool bar at the top of the HEALTH

one

TM screen or use the Hot Key combination CTRL+P

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7) You may also view a print preview of the prescription before it goes to the printer.

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Management of Repeat prescriptions

Creating a repeat prescription

There are several ways to create a repeat prescription from the drug list.

First of all you should select a drug from the drug list on the left.

1. You can use the

mouse

to « Drag & Drop » your selected drug from the drug list to the repeats panel.

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2. You can use the

Hot Key

Combination Alt+right arrow (open editor first) or

CTRL+Alt+Right arrow (by pass edit screen if dosage already defined)

3. You can press the edit button , and tick the « Repeat » on the top right hand side of the edit window

This box can be ticked by hitting the combination keys Alt+R

4. You can also « Drag & Drop » your selected drug from the current

(acute) prescription panel to the repeats panel.

5. You can edit the acute prescription in the acute prescription panel and tick the Repeats box

6. finally it is possible to send a drug from the list of drugs on the left hand panel to the repeats after hitting Enter on it by ticking the Repeats box and un-ticking the prescribe box (bottom left of edit screen)

The repeat prescriptions are saved to the top right hand panel of the PM.

By default this panel shows the repeats but it can also be changed to show other prescription sets from the patient file.

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The repeat prescriptions are saved to the basic medical Information transaction.

These drugs are also automatically visible from the patient file with the

PM closed.

They are included in the « views » tabs on the top left hand side of the patient record.

This view can be made the « default » view for these tabs by using the menu item tools/options/general and changing the default analysis tab setting on the right hand side

Prescribing from Repeat Prescription List

Here is a typical list of repeat drugs in the repeats panel.

Managing the list of repeats :

1. You can select one or several or all drugs in the list as follows :

Select a drug with the mouse. Hold the CTRL key down and then click several drugs to make a multiple selection screen

or hit the Combination Keys

CTRL+A

to select all drugs in the list

3. You can define the « repeat by » quantity by selecting the drugs you require and then simply typing a number such as 3 or 6 for 3 monthly or 6 monthly

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You do this also by selecting your drugs and clicking on the repeat by icon on the tool bar

4. You can define that a drug or selection of drugs is being dispensed by the doctor directly.

5. Once you have made your selection and decided how many months repeats you want to give the patient you are ready to prescribe the repeats to the

« Current prescription » panel, ready for printing. There are several methods of doing this. and prescribe them to the current prescription panel

Note : hitting the F8 key will do the same thing

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current prescription panel

CTRL+Enter and they will be prescribed directly

Stopping repeat Prescriptions

To stop a repeat and record the fact that you stopped it in the patient file you can click on the « stop » button

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You can also indicate the date and the reason for stopping :

Deleting a Repeat prescription

To delete a repeat prescription with no record of the deletion saved, select the drug in the repeats panel and click on the delete button .

Conversion of Repeat prescriptions from 3.7 version of

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This subject is explained at the end of this chapter

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Multiple prescriptions in the same session:

The PM allows you to create more than one prescription in the same transaction.

This may be necessary, for example, when a patient returns, having received a prescription, because they forgot something or if you want to print some drugs on different forms for a single transaction.

To create a new prescription, simply click on the button situated on the tool bar

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The counter to the right of the icon indicates how many prescriptions there are in the transaction and the number of the prescription being currently displayed

In the patient file each prescription is contained in a separate « aggregate » of the item « drug prescription »

Represents an

acute

prescription

Represents a

Repeat

prescription

(orange colour) Represents a prescription «

on hold

»

Regarding the printing, the different instances may be printed separately or on the same form.

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More Details on prescribing :

Searching for a drug

You may search for drugs using various options :

By default, the PM searches for the characters entered in

any part

of the drug name

Thus, if you are looking for « colostomy bags » and you enter the text « colostomy » you will get what you want, even though the item name does not start with the characters entered.

Note:

it is also possible, for example, to search by number. In this case it is necessary to precede the text by a « star » : *

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Example : Search for clonamox 250mg

It‟s possible to change the search options by changing them in the menu item

Options/drug Module. o

Search on any part of the drug name. If this option is

not

ticked, the search is made on the first letters of the drug name only. If this option is ticked, you can search for a drug by typing in letters from any part of the drug name. o

Search on an empty value : If this option is ticked, all drugs in the database will be displayed immediately you open the PM, when you have not typed in any search criteria. If it is not ticked, no drugs will be displayed until you start typing your search criteria. Use the unchecked option if you need the

PM to open faster.

Note:

Some advice : If your search is made on the start of the drug name, you can put a space in first and then you will be searching the following text in any part of the drug name.

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Searching for drugs based on the « Equivalents »

It is possible to filter a list based on the equivalents of a given drug. Click on the button on the tool bar.

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If we choose the first option above « active substance », having first typed

“tenormin” as our search criterion, we get the following result

The PM displays all drugs containing « atenolol» in all its forms.

If I choose « chemical subgroup » as my filter after choosing tenormin I get :

The PM displays all drugs that are selective beta blockers.

And so on… o

Pharmacological class = list of all beta blockers o

Anatomic level = cardiovascular drugs

The filtering of these equivalent classes is based solely on information provided by the database distributor

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Filtering a drug by “Alternates”

This is commonly used to find the cheapest alternative to a given drug.

Let‟s take the tenormin example again: Choose tenormin 100mg tabs

Now right click on the drug name highlighted and choose the option

“alternates” from the list

You can achieve this also by hitting the Hot Keys combination <Alt+A>

Now you will see displayed, a list of all drugs containing atenolol 100mg tabs. This list is automatically sorted from cheapest to most expensive

You may now prescribe directly from this list.

Note:

You can also prescribe the chosen drug by its generic name using this right click menu. You can also create an allergy for this drug from here (see later)

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Prescribing a drug to the active prescription panel

There are several ways to prescribe a chosen drug from the drug list to the active prescription panel.

1) prescribe directly without opening the drug prescription editor : Use the prescribe button or hit the Hot Keys CTRL +N (N for

N

ew prescription)

Note : If a dosage has not been defined for the drug, the drug editor will always appear when you prescribe it

2) Edit the prescription before prescribing: Use the button « Edit » or hit the Hot

Keys CTRL + E (E for

E

dit)

3) Use the mouse to select the drug and drag it to the active prescription panel

4) Simply hit the Enter key. What happens when you hit the Enter key can be defined in the Options. It may be set to direct prescribe or open the edit screen first.

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From the above screen you can see that Ctr+Enter can have the opposite effect to the Enter key..

Note:

If you select the tools/option of « edit before prescribing » and at the same time « prescribe directly from repeats.. » is ticked, hitting the Enter key will open the editor for drugs selected from the database but not when you select drugs from the top right panel (repeats, history..)

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Prescription Editor

The Drug editor dialogue allows you to do the following : o

To prescribe a drug as a repeat

OR

as an acute prescription, or both o

To define and save several dosages for each drug. o

The start and end dates for a prescription, if required. o

To define a dosage schedule which can be given to the patient o

To define a series of other options

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If you wish to send a drug to the repeat panel simple tick the <Repeat> check box.

Pre defined dosage list.

The dosage and start/end dates

The dosage

(planning) schedule

Information for the patient and for the doctor

Other user controlled parameters

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The dosages :

The list of formulations available is now reduced to a manageable number of realistic possibilities. As well as this you can simply enter you own free text formulation. All calculations based on a free text formulation, however, will be the responsibility of the user.

The editor allows you to format the dosage and formulations easily. In the numbers boxes, you can enter not only numbers but also special characters to allow for further flexibility

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For example, for the dosage you can enter the following :

1/2 Tablet, 2-3 tablets (2 or 3), 1

– 1/2 tabs etc.

The automatic calculations will be correct if the PM understands what you have entered.

For the price you can always insert this manually but you are then responsible for any further calculations made there on.

.

The dose edition zone displays all the dosages that were saved by the user, with the default dosage indicated in bold type.

When you first open the module the default dosage for all drugs will be 1 daily for

28 days. The user can change this, save it and it will be remembered for this drug there after.

The PM will calculate the quantity of a drug based on the dosage and the duration of treatment. However, if you modify the quantity manually the PM stops calculating.

If the PM cannot ascertain what the formulation should be, it leaves it blank and coloured in pink.

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The user can then enter his own formulations as follows :

Note the quantity is in yellow. This indicates that the user has manually entered the quantity

Let us take an example of Prednisolone as a prescription.

The PM automatically calculates the quantity based on the duration as input by the user.

If you want to change the Duration, say to 7 days, the quantity will automatically be updated.

Note that the price is also automatically updated. However, if you manually change the formulation or quantity of a drug such that the PM can‟t calculate the price, you can insert the price yourself as below, by simply double clicking on the price.

Please note that this is not recommended unless your formulations are completely unknown to HEALTH

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You may also insert a free text dosage by clicking on the button

or Hit the Hot Keys CTRL+T

Enter any free text you like or choose from the list of common terms offered

(use the Hot keys CTRL+ENTER to create a new line)

As regards the list of dosages, each time you prescribe a drug and enter a dosage for the first time, this dosage is saved to the list of dosages. Every time you prescribe that drug, for any patient, from now on, this dosage is presented as your first option.

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The following commands allow you to manipulate the list of dosages :

: Insert the currently displayed dosage to the list of saved dosages (Ins)

: Update the selected dosage to that of the displayed dosage (CTRL +

S)

: Delete the highlighted dosage (CTRL + Del)

: Select the previous dosage (CTRL + Arrow Up)

: Select the next dosage (CTRL + Arrow Down)

: Make the highlighted dosage the default dosage (CTRL + M)

The dosage schedule

= drug take during the day

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You enter the schedule directly as above individualised for each patient, with a comment if required.

You can enter the actual number of tabs to be taken

You can use, for example, an X to indicate when the medication is to be taken.

You can use fractions or brackets to indicate, for example, an optional dose

Here are some examples :

Prednisolone 5 mg

2 before breakfast, 2 before lunch, 2 before dinner and 2 at bedtime if necessary

Prednisolone 5 mg take before breakfast, before lunch, before dinner

Prednisolone 5 mg

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The icon on the top left border indicates if this table should be printed with the prescription.

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Drug Information

There are several ways to view information on any drug as supplied by the manufacturer :

1. Click on the information icon on the top bar of the PM

2. Hit the combination Keys ALT + Enter

3. Right click on the drug and choose the option « product information »

4. Click the Pill icon on the top right of the drug edit screen

Prescription Manager

– prescribe by disease – sets

In the drug pick list window we can search for drugs « by disease »

The principle here is that you define a prescription set for a particular condition and then you can prescribe the entire set of drugs in one shot to the active transaction.

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The most obvious example for this is helicobacter. In this case you would prescribe the 3 drugs in the normal way from the main

IPU drug list, to the active transaction. You will have decided the dosages while prescribing.

Below we have prescribed 3 drugs to the active transaction for helicobacter. If we select all 3 and right click we can see two new menu items « add to drugs by disease » and

« send to disease »

Once you have created your own new « disease » label, you can add any number of drugs to this disease set for later prescribing the entire set in one shot.

Now you can choose the « drugs by disease » list in the same way as you choose brand/generics etc, and prescribe from there.

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Note that if you have defined a default item for drug sets in tool/options, and if you enter a content into this item, in HEALTH

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that has a corresponding disease set in the PM, this drug set will be automatically proposed

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– as opposite.

Now you can prescribe this «drug set » to the active transaction and all the drugs will be prescribed.

Note : the edit screen will open for each drug if you simply drag the disease. If you hold the

CTRL key down while dragging, the drugs will be prescribed directly if a dosage has already been assigned.

This behaviour is exactly the same for normal prescribing.

Ctrl_Enter or Ctrl_drag = prescribe directly if dosage defined.

Management of allergies/adverse reactions to medications :

The prescription Manager allows you to define both « allergies » and « adverse reactions to medication ». If you define either of these from the drug list, then

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will display an alert if you try to prescribe them. By convention, the

Irish users have adopted the use of the item « Adverse reaction to medication » as the way to declare a drug allergy. We use the item « allergy » to define an allergy against a non drug item such as « cat hair » « house dust mite » etc.

However, using either of these methods in the PM will give an alert if used for a drug.

For the purposes of this discussion we will use the term « allergy » to mean

« adverse reaction to medication » only.

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The adverse reaction may be declared by different methods in the PM.

Direct from the allergy section (lower left panel of the PM)

During the prescription of a drug

When you « stop » a drug, you can give an allergy as a reason for stopping it.

The allergy is normally declared in the allergy panel at the bottom left hand side of the PM. Note : this panel can be hidden by option

The same display is available directly in the patient file

– top left views « allergies »

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Adding an allergy from the allergy panel :

Click the button or hit the combination keys Shift+Ctrl+A

Adverse drug reactions use the « allergen group » as the default drug filter type.

Thus you decide a patient is allergic to penicillin, meaning all penicillins.

This is the commonest way of creating an allergy.

However, you can also declare an allergy using other drug ingredients as seen in the drop down list.

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ATC Code:

(Anatomic Therapeutic Chemical Classification)

Filters the drugs by their therapeutic actions e.g. anti hypertensives etc

Type in the first few letters and the list will be reduced. You can also click the button to choose from a hierarchical list.

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o

Ingredients :Filters the drugs by their ingredients e.g. potassium, iodine etc. This may not be very useful for most users o

Free text: You can also use free text descriptions to enter your own drug names, perhaps if they don‟t exist in the other lists.

Note that the entries to the free text list will not trigger an alert in the PM when you prescribe them. They will, however, be visible in the allergies panel

You can give an adverse reaction a « severity index » from 1

– 7

Defining an adverse reaction directly from a selected drug

After selecting a drug (from the drug list or from the repeats panel), you can declare

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When an adverse reaction is created using this method, the coding possibilities are different

In the following examples we used the drug name « augmentin » as our selected drug.

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1. ATC code: The dialogue displays the ATC codes related only to the selected drug

You can choose between a specific ingredient and broader classifications as below.

2. Ingredients : The dialogue displays the different ingredients in the selected drug. You can choose one or several ingredients

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Product: This is the default display when you choose an adverse reaction when selecting a drug. o

Free text: This is the same mechanism as when defining an adverse reaction using the allergy panel.

Defining an allergy as a cause for stopping a drug

When you stop a drug, say a repeat, you are asked the reason for stopping. One of the reasons is an allergy/adverse reaction

You can also edit an existing adverse reaction ( edit the reaction or gravity only)

You can delete an adverse reaction.

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Management of the private drug database

To select a drug from your own private list of drugs click on the drug database selection button on the top left hand panel. You will see a drop down list.

You can also use the Hot Key combination Shift+Ctrl+B.

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The tool bar at the top of the PM allows you to :

Create a new private drug

Edit the selected private drug

Delete the selected private drug

Create a new private drug

Click the button to add a new drug to the private database.

You should fill in the boxes as in the dialogue below

Enter the drug name. The drug name should include the strength and the strength unit.

The rest of the form is optional.

In the case of liquids or topical medications you should also fill in the « pack size units » boxes.

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Editing of a private drug

Click the button to edit the selected private drug. The same edit dialogue box is opened and you can change any of the information

Deletion of a private drug

Click the button to delete the selected private drug

IMPORTING PRIVATE DRUGS FROM 3.7 versions of

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You can import all the existing drugs from you own private database. To do this you

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menu

The following screen then pops up to allow easy import of the database

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Prescription Manager

– Practice Formulary

Practice formularies

can be defined in the prescription manager options window. The

Prescription manager options can be accessed by clicking on the main

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Below is a screenshot of some of the prescription manager options :

We have three user-defined formularies. These can be named as you wish. However the first formulary is named « practice formulary » by default.

Once you have set up the practice formularies in the tools options menu, you can send drugs from the IPU list to your formulary for inclusion. You do this by choosing the drug from the main IPU list, right clicking on the drug and clicking « send to search form » practice formulary

You can do the same thing from the repeats window and from the active transaction window. In this way you build up a list of preferred drugs that suits your own practice.

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The prescription Manager Options

– Summary

The prescription manager options can be accessed either by the

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Tools/Options/Prescription Module.

OR

By clicking the button in the main bar of the prescription manager.

1.

Search on any part of the drug name:

If this is ticked (the default), then when you type some letters when searching the IPU list, these letters need not be the first few letters of the drug but can be found anywhere in the drug name.

Note :

Even with this option unchecked, if you put a space before the first letters of your search, you will get a wide search i.e. it will act the same as if you had the option ticked.

2.

Search on empty value:

If this is ticked, the IPU list is loaded when you open the PM. Thus you will see some of the first drugs in the list before you type anything.

If this is unchecked, the list remains empty until you type something. This should make for quicker opening of the PM because the list does not have to be loaded until you start typing.

3.

Stay active for (28) days:

Normally when you prescribe a drug, it remains active for the duration specified in the dosage. Sometimes this is not appropriate. For example, if you prescribe

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GTN spray 1 dose once a day, it will remain active for over 100 days. By using this options you control how long HEALTH

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will consider the drug « active ».

Note that all repeat prescriptions are considered « active » until they are removed from the repeats.

4.

Insert the prescription at the end of the transaction :

If not ticked, the prescription will be entered at the highlighted item in the transaction

5.

Default repeat number :

When this number of repeats have been issued, HEALTH

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will grey out that drug in the repeats so that it will have to be « re-activated » before it can be prescribed again. If this number is changed (to 12 say), then for all future prescriptions the default repeat number before checking will be 12.

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6.

Apply to all drugs :

This relates to 5 above. If this is ticked, then when you change the default repeat number, all existing repeats will revert to a default of 12.

7.

Display overdue repeats in red :

If the month is up, for a single month‟s prescription, the drug will appear in red.

8.

Default duration for prescriptions :

The default duration for repeat drugs is 28 days. You can change this default here to, say 30 or 31.

9.

Drug set :

If this is ticked, then if you have a drug set by disease matching this term, that drug set will be automatically proposed when you open the PM.

10.

Layout:

This is self explanatory. It is here that you can decide the default views for the left and right upper panels of the PM.

11.

ENTER KEY

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12.

Interactions:

here you can decide what level of interactions you want the PM to warn you about. The interactionsalert can also be turned off for drugs prescribed from repeats.

13.

Print options: show print dialogue -

This determines whether you print directly or show the printer list before printing when you hit the

print

button in the

PM. This option is also available in the print screen itself

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Conversion of Repeat prescriptions from 3.7 version ofHEALTH

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Because we are using an entirely new drug database, the IPU database, as our pick list in version 5.0, we have to “convert” our 3.7 drugs, which were entered using a different database, the IDDF database. There is no link between the two databases which would allow a direct “translation” of the IDDF drugs to the new IPU drug list.

However HEALTH

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does have a list of all the drugs in each patients record and it can directly enter these drugs into the repeats window of the version 5.0.

You can continue to prescribe these drugs from the repeats as you have always done with no effort on your part. However, these prescriptions will have no link to the new drug list and this will lead to some restrictions, namely there can be no

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update the prices or other drug information, for these drugs.

We therefore strongly recommend that you use the “convert repeats” button on the repeats panel of the PM so that HEALTH

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can attempt to pick a drug from the IPU list which is the same as that you have already prescribed. These drugs are coloured orange in the new PM until they are converted.

Before conversion:

Drugs in yellow are from the IDDF database. Drugs in white are from the private database

After Conversion:

In this case all the drugs were successfully converted.

Note: the private drugs are NOT converted, they can‟t be! As most of the drugs you previously had in your private database are not contained in the IPU database, we suggest you replace these drugs with those from the IPU drug list. You can, if you wish convert your own private database to a new 5.0 private drug database.

This will be described later.

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Conversion of 3.7 private drug database to a 5.0 private database

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It has already been noted that most of the drugs you used from your private drug database in 3.7, are available now in the new IPU drug list. If you replace these drugs with those from the new drug list you will have the following advantages : o

The names of the drugs/appliances will be correct as in the MIMS. o

The drugs will have all the attributes of any other drugs from the IPU, namely, a,

interaction, pricing information, drug information, all of which were not available

with drugs from the private list.

With the Prescription Manager (PM) open, click on the HEALTH

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« Prescriptions » :

From here you can import all you old private drugs to the new 5.0 private drug database.

NOTE: Drugs prescribed from the 5.0 private database will have the same “properties” as those in the 3.7 private drug database: they will be entirely user controlled and will not have any relationship to the IPU list.

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To Change Between the Legacy Appointments

System and the New Multiple User Display Appointments

System

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1) Go to Tools

– Options – Appointments. Click on Multiple User Display.

2) Click OK.

3) Close your patient selector and reopen it.

4) Go to the appointments tab. You will now see the multiple user display.

5) You will now need to configure the users.

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Configuring the Multiple User Display

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Appointments

To Configure Users

Note: If you want to configure all users at once you must log in as administrator.

1) Click on Config

– Add/Edit Users.

2) Highlight the user on the left. Click on

Display in appointment planner

on the right. You can also select the user group, i.e. GP/Nurse, default room, and default appointment type. For each of these click on the three dots to see choices.

3) When you click onto another user, it will prompt you to save changes.

4) Then highlight the second user and do the same thing.

5) If you wish to change the order in which the users will appear on the planner, highlight a user and click up or down arrow to move the doctor/nurse up or down the list.

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To Configure Users ..continued

6) Advanced settings:

If you wish to allow others to create/modify your appointments, you must click on the “advanced” button (a) and put a check-mark in the “others may create/modify appointments” box.

7) Click on Save & Exit.

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To Configure Planner View

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1) Click on Config

– Planner View.

2) To edit the day start and day end times just click on the down arrows and select new times. You can also edit the default duration of appointments and the display interval of the planner.

3) You can change the colour scheme by clicking on any of the colours and selecting a new colour i.e. to change the Planner Background colour, click on the light blue square beside „Planner Background Items‟ and a colour chart will come up. Choose your new colour and click ok.

4) Click save and exit when finished.

5) Close your patient selector and reopen it.

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To Configure Recurring Timeblocks

1) Click on Config

– Recurring Timeblocks.

2) Highlight user and click add.

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3) Type in time block name and choose day of week and time.

4) Click save and exit.

5) If you wish to copy the time block, e.g. from Monday to Tuesday, highlight

Lunch on the right hand side and click Copy Day.

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To Configure Recurring Time blocks ..continued

6) Choose Tuesday from the drop down list and click save.

7) If another user has the same lunchtimes Click on Copy to User. Select user from drop down list and click Copy.

8) Click close.

9) Click save.

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10) Close your patient selector and reopen it.

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To Configure Holidays/Leave

1) Click on Config

– Holidays/Leave

2) Click on New

3) Select user from drop down list and set start date and end date.

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4) Click save and exit.

5) Close your patient selector and reopen it.

To Convert your Appointments from the Legacy System to Multiple

User

Display

Please note:

A. This process can only be done once. When the appointments have been converted they can not be converted to back to the legacy appointments system.

B. Any messages in the message panel of the legacy appointments system will not carry over to the new system.

To convert the appointments:

1) Log into HEALTHone as administrator i.e. with username = Admin, password =

Admin.

2) In the appointment tab go to Config

– Convert Legacy Appointments.

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To Convert your Appointments from the Legacy System to Multiple

User

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Display ..continued

3) Select user to convert and click convert.

4) Click OK.

5) If there are any conflicting appointments, click on the conflicts tab for more details.

6) Click Exit.

7) Repeat steps 3

– 6 for each user whose appointments you wish to convert..

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Using the Multiple User Display Appointments

To Add a New Appointment

1) Double click on the time slot you wish to add an appointment to. You can also highlight the time slot by clicking with the mouse, then press space bar to

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2) Use the patient selector to locate the patient the appointment is for

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To Add a New Appointment ..continued.

3) Edit any details required such as Appointment location and appointment type and duration. If you want to put in a note/comment hit F3 or click on show advanced detail.

4) Click Save and Exit.

To Edit an Appointment

To edit an appointment after it has been made,

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1) Highlight the appointment slot and press space bar or

2) Highlight the appointment slot and right-click, and then choose edit from the menu.

3) You can change time, date, doctor, location or appointment type.

4) Click save and exit when finished.

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Work-flow

It is important to follow a work-flow procedure in bringing patient through the practice. This is done as follows:

1) When making a new appointment, it appears in one colour, with its status set to

“confirmed”.

2) When the patient arrives at the practice, you should set their status to

“present / waiting” as follows:

3) When the patient is to be seen by the GP/Nurse, they select they patient name and click “View record”. You can also double-click on the patients name to view record. The following screen will appear:

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4) If you say yes, it will set the status to “in appointment” and also open the patient file. Then when the GP/Nurse closes the patient record, the status will be automatically updated to “complete”.

5) If you say no, it will merely allow you to look at the patient record without changing the status.

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Repeat appointments

You can make a repeat appointment for a patient easily by selecting an existing patient appointment, rightclicking and selecting “copy” – this will copy all the details of the selected appointment into a new appointment

– all you need to do is change the date and time. When you are in the appointment editing screen, if you click advanced detail you can view the calendar and select a free time slot.

To View Patient’s Appointment History

1) Highlight patient‟s appointment in appointment screen.

2) Right-click on appointment and click on appointment history.

3) A list of all appointments past and future for this patient will appear.

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To Locate Appointments for a Particular Patient

1) Click on button below calendar.

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2) Type in patients surname as before.

3) Double

–click on patient name or click View History for Selected.

4) Alternatively you can select any appointment for any patient and right click and select Appointment History. This will list all appointments for this patient.

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Messaging Feature

To Send a Message to Another User

1) Click on New.

2) Select the recipient from the drop down list.

3) Type Message

4) If you wish to relate the message to a particular patient file, click

select patient

.

This will allow you to choose the patient from the patient selector.

5) To send a carbon copy or blind carbon copy to another user, click

advanced detail

then

add cc

or

add bcc

as required.

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6) Click Send.

To View Received Messages

1) Click on the drop down arrow beside view and change to received.

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To View Received Messages(cont.)

2) Double click any message to read it.

3) If the message is relating to a patient you can click

view patient

to open the patient‟s file.

4) There are options to reply, forward or delete the message.

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Correspondence

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has its own text editor which can be used to quickly write

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In its simplest form the text editor can be used to write free format letters, like any other word processor, and print/save these. However; there is a more powerful aspect to the text editor in that it has a number of pre-set documents, called templates which are used to automatically extract information from a patient‟s file and merge this into the new document.

HEALTH

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TM has a number of templates which are supplied as standard. In time you will be able to create new templates of your own. This document will introduce you only to how they are used.

See also the chapter on

Mail Merge

to see how these templates can be further enhanced

Free Format Letter

To use the text editor to write a free format letter you do not need to have a patient‟s HCR open.

Creating a New Letter

1) Select the menu sequence:

File / New / Document

The text editor window opens with a new blank document.

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Speed

Toolbar Formatting Toolbar

Ruler Tab Bar

Insert Cursor (flashing)

Insert Cursor Location

Indicator

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Free Format Letter

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Text Editor Toolbars

In general, if you wish to know what a toolbar button does simply place your mouse on to it

– exactly like you would with the HEALTH

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– and a description of each will appear beneath the mouse cursor.

Speed Toolbar

This toolbar contains buttons which perform common functions and save you time.

Formatting Toolbar

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The Format toolbar is used to change the appearance of text. The controls affect two distinct type of text:

The Character

Any letter or letters that are currently selected.

See next page for text selection techniques.

The Paragraph

Any amount of text ending in a RETURN character.

(i.e. inserted by pressing the RETURN key).

In the illustration above arrows (with the exception of the zoom button) point to buttons which control the character appearance and braces indicate those that change a para graph‟s appearance.

Zoom

Size %

Bold Italic Underline

Style Style Style

Font Size

Selector

Font

Selector

Paragraph Alignment

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Controls

Left, Centred, Right, Justified

Paragraph Tab Controls

Left, Right, Decimal, Centre

Quick Text

Line

Use

External

Text Editor

Insert a

Database

Field

Buttons only used for creating templates

Archive

Document Print

Preview

EMAIL

Document

Import picture

Import text

Header/

Footer

Quick Text

Paragraph

Import scanned text

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Free Format Letter

Text Editing Techniques

To type text:

Position the insert cursor (flashing line) where the new text is to appear

(by clicking the location once with your mouse or by using the four

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Note:

The insert cursor can only be positioned where text currently exists. See below to find out how to create blank lines.

To create a Paragraph:

Press the RETURN key. Any amount of text ending in a RETURN character is considered by the text editor as being a paragraph.

To create a blank Line:

Press RETURN without typing anything else. A blank line is simply an empty paragraph.

To create a New Line:

Hold down the SHIFT key and then press RETURN.

Don‟t confuse this with a blank line. A new line will appear identical to a blank line but is considered by the text editor as being part of the paragraph above it. Any appearance changes to the paragraph above will also be reflected in the new line.

Correcting Mistakes

Small typing errors: Position the insert cursor to the right of the error and press the Backspace key (



right most key, top row of keypad) to delete. Re-type correctly.

Large errors: Where deleting each character in turn is not

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select

(see

Selecting Text

a little further on) all the text which needs deleting and then press the DELETE key.

Other Mistakes This is where something has happened, possibly unexpectedly. Select the menu sequence

Edit /

Undo

. The text editor remembers your last action and reverses it, but be careful, only the last action is remembered, so you must correct the mistake before doing anything else !

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Free Format Letter

Text Editing Techniques

To practice these techniques:

1) Select a paragraph in this book and type it. Do not press the

Return

key (even at the end of a line) until the entire paragraph has been entered.

2) Press the

Return

key again to create a blank line.

3) Type another paragraph.

4) Practice the editing techniques outlined above.

5) Select the following menu sequence

Edit / Select All

Entire text selected

6) Press the

Delete

key

Page is blank once again.

7) Select the menu sequence:

Edit / Undo

Page re-appears. Text is still selected.

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8) Press the

Delete

key once again.

You once again have a clean page.

Selecting Text

This is an important action to master, because you will need this to change the appearance of both characters and paragraphs and also edit text quickly.

To select:

A Character: Place the mouse cursor to the left of the character to be selected, hold down the mouse key and drag the mouse cursor over the character required.

Now release the mouse key.

A Word Place the mouse cursor over the middle of the word required and click twice quickly.

Alternatively, drag the mouse cursor over the entire word as described for character selection.

A Line Move your mouse cursor to the left of the line required until it becomes a right facing arrow. Now drag downwards for one line.

A Paragraph Same as for the line but keep dragging down until the paragraph is selected.

Any Amount Click once to place the insert cursor at the beginning of the selection. Use the scroll bar if necessary to view the end point of the selection.

Hold down SHIFT and click once on the end point.

All Text Select the menu sequence:

Edit / Select All

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Free Format Letter

Changing the Appearance of Text.

The Character: First select the character(s) to be altered, as described on the previous page. Now select the button required on the

Formatting Toolbar. Alternatively: Select the menu sequence:

Format / Font

and change the settings as required.

The Paragraph Position the insert cursor anywhere inside the paragraph to altered. Now select the change required on the Formatting

Toolbar or, alternatively select the menu sequence:

Format /

Paragraph

.

To practice these techniques:

1) Select a paragraph in this book and type it. Do not press the

Return

key (even at the end of a line) until the entire paragraph has been entered.

2) Practice selecting Characters, Words, Line, Paragraphs and entire text.

3) Select a word and experiment with the settings in the:

Format /

Font

menu.

4) Make sure your insert cursor is positioned inside the paragraph just typed and experiment with the

Format / Paragraph

menu.

Page and Document Settings

In addition to be able to type, edit and change the appearance of text you will also need to control document and page settings.

Set Paper Size: Select the menu sequence

Format / Document

and set paper width and height size in the boxes provided.

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Set Margins Select the menu sequence

Format / Document

and set top, bottom, left and right margins in the boxes provided.

Insert a Page

Break Position the insert cursor where the break is required and select the menu sequence

Insert / Page Break

.

Remove a

Page Break Position the insert cursor underneath the page break and press the Backspace key (



right most key, top row of keypad) key once.

Printing Your Document

To Preview Before Printing:

1) Select the menu sequence:

File / Print Preview

or alternatively simply click on the print preview button on the Speed Toolbar.

2) Click with the left mouse key to ZOOM IN or right mouse key to

ZOOM OUT the preview of the page.

To Print

3) Select the menu option:

File / Print

. Select the page range and number of copies required. Select

OK

.

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Free Format Letter

Saving and Archiving Your Document.

There is a difference between saving and archiving.

Saving

means to save your work as an individual file on to your computer;

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Archiving

means to attach the document to an Item in the current transaction of the patient‟s HCR. So, to archive a document the patient‟s file must be open and a new transaction created. HEALTH

one

TM will prompt you for the name of the item in which the document is to be archived, normally this would be the item

archived document:

See „Archiving a Consultant‟s Letter‟ later in this session for an example of archiving. For now we will simply SAVE this document:

1) Select the menu sequence:

File / Save

2) Type in a name for the document

3) Click on the

Save

button.

Closing a Document (and the Text Editor)

Now that you have saved the document we can close it. If you choose to close the document and you haven‟t saved any changes HEALTH

one

TM will prompt you to do so.

4) Select the menu

File / Close

If you have already saved the document it will now close and the text editor will automatically close as well.

If you have not saved the document HEALTHone

TM

prompts :

5) Select Yes or No. Cancel brings you back to the document to continue editing.

If the document had never been saved before you would now be prompted for a file name and destination directory in which

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Upon completion the document will close and the text editor will automatically close as well.

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Using Templates

Templates are designed to be used in conjunction with patient data.

They provide a quick method of writing everyday letters in the practice.

Once a letter has been created using a template in can be edited and enhanced by using the same techniques employed in writing a free format letter described earlier.

As an example we will send Sarah Tennant to see a consultant with a referral letter

– generated by HEALTH

one

TM

.

Next, we will archive the consultants reply into her file.

Opening a Health Care Record

1) If the Patient Selector window is not already open select the menu

File / Open / HCR

.

Patient selector window is now open.

2) Type:

Te

in the surname filter

3) Select

Sarah Tennant

in the patient list.

4) Click on the

Select

button.

The Health Care Record for Sarah Tennant opens.

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Creating a New Transaction

We wish to record the fact that she has been referred to hospital.

1) Click once on the

Create Medical Transaction

button on the

Transaction Panel Toolbar.

The Transaction Properties dialogue box appears.

Transaction Attributes

2) Complete the Transaction Properties dialogue box by ensuring that the attribute values are set as follows:

Type

Contact

Name

Consultation

Responsible

Your name

Date of event

Current date and time

Speciality

general practice

Legal Structure

As is

Problem

None

3) Click on the

OK

button.

New transaction is completed and appears at the end of Sarah

Tennant‟s medical chapter.

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Using Templates

Inserting the Referral Item

1) Click once on the

ItemSelector

button on the Item Panel Toolbar.

The Item Selector window opens.

2) Type:

Ref

in the Item Find box.

Item list reduces to those that begin with „Ref‟.

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3) Select the item:

referral

Click on

OK

The Item „Referral:‟ in inserted into the new transaction and its associated list box opens.

4) Ensure the term

Hospital

is selected. Click on the

Insert

button. Select any hospital from the sub list. Click the

Insert

button once more.

The terms „Hospital‟ and its name are entered as a response.

The Referral Item window is still open.

5) Click once on the Associated List button (to the right of the blue book)

Associated list re-appears.

6) In the find box type:

R

Select the term

respiratory medicine

in the list. Click on the

Insert

button. Select

respiratory function tests

from the sub list. Click the

Insert

button once more. Click

Close

to close the associated list box

7) Click

OK

to close the

referral:

item edit box.

8) Save and validate this transaction by click on the diskette button on the HEALTH

one

TM standardtoolbar.

Creating the Referral Letter

Now that her referral to the consultant has been recorded we now need to give her a letter. For this we need to select the transaction which best describes her complaint. Selecting this will make it the

current transaction

and the template will pick up its details and merge them into the referral letter that it creates.

The transaction which describes her complaint best is the second one in the medical section (the first transaction is her basic medical information).

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1) Select the transaction immediately beneath the basic medical information one by clicking on it once in the Transaction Overview panel.

The selected transaction is now considered as the „current transaction‟

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Using Templates

Creating the Referral Letter

2) Now select the menu sequence:

Tools / Run template

A box of templates appears.

3) Select the template:

quicklet.cvs

and click on the OPEN button.

The quicklet template runs and a new letter is created and displayed in the text editor window. See Fig.1

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4) Use the scroll bars to view the full contents of the letter.

5) Use the editing techniques to enhance the appearance of the letter and alter its contents.

Printing Your Document

To Preview Before Printing:

1) Select the menu sequence:

File / Print Preview

or alternatively simply click on the print preview button on the Speed Toolbar.

2) Click with the left mouse key to ZOOM IN or right mouse key to

ZOOM OUT the preview of the page.

To Print

3) Select the menu option:

File / Print

. Select the page range and number of copies required. Select

OK

.

Fig.1 Text Editor Window

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Using Templates

Saving the Document.

1) Select the menu sequence:

File / Save

2) Type in a name for the document

3) Click on the

Save

button.

Closing a Document (and the Text Editor)

4) Select the menu

File / Close

If you have already saved the document it will now close and the text editor will automatically close as well.

If you have not saved the document HEALTH

one

TM

prompts :

5) Choose your option from this list and click Yes.

If you choose „In HCR as multimedia object‟, it will save the document into the patients file.

If you choose „In HCR as free text‟, it will save the text of the letter into th e patient‟s file as free text.

If you choose „Save as external file‟ it will save the document as a file on your computer.

Upon completion the document will close and the text editor will automatically close as well.

Note: If you click No, the document won‟t save, and if you click

Cancel it will bring you back into the letter to continue editing.

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Archiving a Consultant’s Letter

OK Now lets assume that she has seen the consultant and you have received a written reply. To record this we once again create a new transaction:

Creating a New Transaction

We wish to record the contents of her letter in her file.

1) Click once on the

Create Medical Transaction

button on the

Transaction Panel Toolbar.

The Transaction Properties dialogue box appears.

Transaction Attributes

2) Complete the Transaction Properties dialogue box by ensuring that the attribute values are set as follows:

Type

Contact

Name

EXPERTS REPORT

Responsible

Your name

Date of event

Current date and time

Speciality

respiratory medicine

Legal Structure

As is

Problem

None

3) Click on the

OK

button.

New transaction is completed and appears at the end of Sarah

Tennant‟s medical chapter.

Create a New Document

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1) Select the menu sequence:

File / New / Document

A new document opens

2) Type:

Mrs Sarah Tennant

Seen by Mr. H Richards

– 17 th

October 1998-10-29

Upon examination I have found severe throat pharyngitis however,

I feel that with intensive antibiotics this will clear.

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Archiving a Consultant’s Letter

1) Click once on the

Archive

button on the Speed Toolbar.

Prompt to Archive now appears.

2) Select

In HCR as free text

It will automatically save it into HEALTH

one

TM

under item:

Report and close the text editor.

Finishing this Consultation

If all has gone well Sarah Tennant‟s current transaction should now appear as illustrated below in Fig.2:

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Save and Validate this transaction by selecting

Save

from the

File

menu.

Close Sarah Tennant‟s file

Exit HEALTH

one

TM

Fig.2 Sarah Tenant’s Current Transaction

Archived document completed.

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Scanning pictures in

HEALTH

one

TM

To scan within HEALTH

one

TM

we use a program called Irfanview. This is available on the HEALTH

one

TM

installation CD.

To Install Irfanview:

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Insert HEALTH

one

TM

installation CD. It will open an installation screen automatically. Click on Cancel.

Open My Computer. Right click on the CDROM drive and left click on explore.

Open the directory called Irfanview. Double-click on iview392.exe to install.

* Please note the setup screen contains an option to install eBay shortcuts and toolbar. This is not necessary for the installation of Irfanview so you may un-tick these if you wish.

After Installation of Irfanview you should double Click on the file called

Irfan_ini.exe, also found in the Irfanview directory on the CD.

After installing Irfanview, you must link Irfanview to your scanner driver.

To do this, open Irfanview, click on file - "select twain source" and choose from the proposed list. (If there is nothing to select, you scanner driver is not installed and you should contact the providers of the scanner).

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In HCR as a multi-media object

Selecting to archive a document as a multi-media object will also prompt for an item to save it in (use

archived document

)

– however, an association is made with an application program (a word processor for example). The icon for the associated application program is used to represent the document in the patient‟s file. Below is an example of how a document archived as a multi-media object associated with the Microsoft Word application will appear:

Double clicking on this icon will launch the associated application program and display the archived document.

The application program that the document will be associated with is set via the

Tools / Options / Multimedia association

menu.

Save as an external file

Selecting to archive a document as an external file will prompt for a file name and destination directory. This document is NOT linked to the patient file.

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Scanning pictures in

HEALTH

one

TM

Then go in to HEALTH

one

TM

.

1. Go to Tools

–options – scanning.

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2. External scanning software should point to "c:\Program

Files\IrfanView\i_view32.exe"

3. Item used to store scanned images = “archived document” or “report” or whatever you wish.

Now HEALTH

one

TM

is set up to scan pictures.

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Scanning pictures in

HEALTH

one

TM

To scan a single page:

1. In HEALTH

one

TM the button for “insert multimedia object” (camera),

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3. Irfanview will open automatically. Click on File - Batch scanning.

3. Don't change any options in here. Just click OK.

4. Your picture should now scan. When it is completed it will show in

Irfanview.

5. Close Irfanview. The picture will have saved into HEALTH

one

TM

.

6. To add a comment, go to Insert item, choose comment and type in your comment.

7. Save and validate the transaction.

To scan multiple pages:

A. Repeat steps 1

– 4 as above.

B. Instead of closing Irfanview, click on File - Batch scanning again.

C. Click OK.

D. Repeat for each page you want to scan

E. When completed close Irfanview.

F. The pages will have saved into HEALTH

one

TM

as one file.

G. To add a comment, go to Insert item, choose comment and type in

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H. Save and validate the transaction.

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Own Notes

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Laboratory Data Messaging

Laboratory results are recorded in the patient's file by:

Manually entering the data

Automatically receiving the data via the Data Exchange Module

Manually Entering Laboratory Results

1) Create a new medical transaction. Leave the transaction Type as

contact

but change the Name to

Lab

.

2) Click on

OK

to create the transaction.

3) Insert the sequence

haemoglobin

or

biochemistry

as required and record the results.

Automatically via the Data Exchange Module

Laboratory

Surgery

Via EMAIL, diskette or electronic transfer

Via

HEALTH

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Data Exchange Receive module

Data Exchange Module

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INBOX

Definition Files

Phase Three: INBOX to Patient File:

Controls whether data is automatically or manually integrated into patient's file.

HEALTH

one

TM

Patient File

Definition

Files

Phase

One

Phase

Two

Phase

Three

Automatically Importing Lab' Results

Definition Files

Phase Two: Data to INBOX:

Describes where the lab data is located on the receiving computer and how to translate it into

HEALTH

one

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Automatically via the Data Exchange Module

Figure 4-1 illustrates the process of transferring data from a laboratory to the patient's file via HEALTH

one

TM

's Data Exchange Module (DXM).

There are three phases in this process:

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Collection of data from the laboratory

Transfer the data into the Data Exchange Module

INBOX

.

Transfer the data from the

INBOX

to the patient's file.

Each laboratory has a

Definition File

created for it in the DXM. This definition file defines:

The method of data collection, i.e. Diskette, Email - other.

Where the data is located on the receiving computer.

Controls how it is converted into a format that HEALTH

one

TM can understand.

Controls how the DXM transfers the data into the patient's file.

Phase One - Collection of Data from a Laboratory

This could be in the form of a diskette posted from the laboratory, or, more commonly via EMAIL to the practice or some other form of electronic data transfer.

Consult the laboratory to determine which method is used.

Regardless of the method used the data will be in a folder/Email Inbox on the receiving computer once phase one is completed.

Phase Two - Transfer the Data into the Data Exchange Module

INBOX

1) Click on the Data Exchange Module

Receive

button on the

HEALTH

one

TM

toolbar. (Illustrated opposite)

The laboratory definition files are displayed.

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2) Select the definition that represents the laboratory that the data is being imported from. Click on the

Execute

button.

If the definition file option to

'display a list before importing' has been set an additional dialogue box now appears (see

Creating a Definition File later in this section)

Select the definition of the laboratory being imported from here and click the

Execute

button.

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Phase Two - Transfer the Data into the Data Exchange

Module INBOX

3) If the

Select files to integrate

box appeared select the files to import by ensuring there is a tick mark against them in the

selected

box. Click

OK

The laboratory data is moved into the data Exchange Module

Inbox. A results window appears to indicate how many errors were encountered.

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Phase Three - Transfer the Data from the INBOX to the Patient's File

We now open the Data Exchange Module and validate the imported data and resolve any errors that may have occurred.

1) The Data Exchange Module (

DXM

) can be opened at anytime by clicking on its button on the HEALTH

one

TM

toolbar. (Illustrated opposite). However, if you completed phase two by clicking on the

Details

button the

DXM

would have opened automatically.

DXM is now open.

Automatic Merging

If the laboratory definition file had been configured to automatically merge results into the patient files (see

Creating a Definition File

later in this section) this would have occurred and only errors would be left to be resolved. Managing

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Click here to return to the

Receive Module to collect more data.

Click here to open the

Data Exchange Module

INBOX

.

Transaction

Locator

INBOX / OUTBOX

Selector

DXM

menu View transactions by their status selector.

Merged

status indicates a successful merging into the patient's file

DXM Module (INBOX)

Transaction

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Selector

Box

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Automatically via the Data Exchange Module

Phase Three - Transfer the Data from the INBOX to the

Patient's File

Manual Merging

Many practices would validate the results before merging them, in which case all results would now be

waiting

to be validated in the Data Exchange

Module Inbox.

See Fig. 4-3

Viewing & Validating a Waiting Transaction

1) Click once on the transaction selector box to select the transaction to be validated. See Fig. 4-2

2) Click on the DXM menu

View

button (Illustrated opposite). See

Fig. 4-2

The transaction opens to be viewed.

3) Click on the

Validate

button and click

OK

when prompted to validate the transaction. Click

OK

for second prompt. Close the

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X

in the top right hand corner.

DXM module once again in view and the selected transaction

Action column indicates that it has been validated. See Fig 4-

4

Waiting

status indicates that user intervention is required before merging into the patient's file

DXM Module (INBOX)

Click here to validate this transaction.

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Automatically via the Data Exchange Module

Phase Three - Transfer the Data from the INBOX to the Patient's File

Manual Merging

Viewing & Validating a Waiting Transaction

If the selected transaction had been viewed but not validated the Action icon would indicate that it had been viewed.

Merging

Waiting

Transactions

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1) Select the transactions to be merged. Use

Ctrl + Click

to select more than one if required.

2) Click on the DXM menu

Merge

button (Illustrated oppoiste)

Provided there are no errors the transaction(s) is(are) merged into the patient file(s).

This completes the technique of manually merging transactions.

Managing DXM Errors

If a patient file cannot be located for an imported transaction the DXM module can be set to manage this in one of two ways:

Automatically create a new file for the patient

Set the transaction status to 'Not Found' and await user intervention to resolve the problem

The choice of action is controlled via the lab Definition file. See

Creating a

Definition File

later in this section.

Note:

If the definition file had been set to always validate transactions then all transactions, including the

not found

, are set to an initial status of

waiting

. Only when an attempt is made to integrate the transaction will a dialogue box appear requesting your choice of action:

Validated icon

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Viewed icon

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Managing DXM Errors

Automatically Create a New Patient File

Initially this may seem the most sensible thing to do, however, labs do make mistakes, and the problem could be that the patient's name has simply been spelt incorrectly.

Mark the Transaction as 'Not Found'

With this setting the transaction will appear in the DXM INBOX as 'Not

Found'.

Now there are two possibilities:

The patient genuinely does not exist

The patient does exist but their name has been spelt in-correctly

In all cases

1) Select the transaction and then click on the

Correct

DXM menu button illustrated opposite.

The DXM Correct Identifiers window appears. In it is listed all

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If the Patient Does Not Exist

2) Click on the Correct Identifiers window

new

button.

The patient file is created.

3) A prompt appears to confirm creation. Click

OK

. Now go to step 6)

If the Patient Does Exist

2) In the Correct Identifiers window click on the patient file that the transaction is to be integrated into and click the

Select

button.

3) A prompt appears to confirm integration. Click

OK

4) A notice appears to inform you it has been done. Click

OK

Not found patient.

Patient's that almost match, i.e. with the same surname

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Managing DXM Errors

If the Patient does exist ..continued.

5) Two things now occur:

The transaction is integrated into the selected patient's file.

The name error is remembered for this lab and will be automatically corrected next time if set to do so in the definition file advanced options. (See HCR Identifiers below)

6) Click the Correct Identifiers window

Cancel

button.

Window closes and DXM window back in view.

7) If you are ready to quit the DXM module click on the cross in the upper right hand corner of the DXM window.

HCR Identifiers

Whenever a lab result is

not found

and later merged into an existing patient' file

HEALTH

one

TM

creates an

HCR identifier

to record the match between the name used by the lab' and the name of the patient merged too. If the same lab' returns more results for the

not found

patient HEALTH

one

TM

will automatically merged them into the correct patient's file.

The process of creating HCR identifiers is automatic, however, there may be times when you need to delete an identifier if, for example, you accidentally merged the

not found

data with the wrong patient.

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To do this:

1) Click on the

display HCR identifier mapping

DXM menu button illustrated opposite.

HCR mapping window appears.

2) Select the HCR mappings to be deleted and click on the

Delete

button.

3) When completed click the

Close

button to return to the DXM window.

Name used by Lab' Actual patient to be merged too

Click this column to select HCR

Mapping(s) to be deleted and click the

Delete

button

Type in the filter boxes to locate the patient mapping you require.

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Tidying the INBOX

All transactions imported into HEALTH

one

TM

arrive in the DXM INBOX.

From time to time it will be necessary to locate specific transactions and perform

housekeeping

on the INBOX.

Locate Specific Transactions

1) Open the DXM module

DXM window opens.

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2) Use any of the techniques above to locate the transaction(s) required.

Selecting Transactions

1) Once the transaction(s) required have been located they can be selected individually by clicking once on the transaction selector column to the left of the transaction.

2) Hold down

Ctrl

and

Click

the selector column to select multiple transactions.

3) Drag select the selector column to select contiguous transactions.

Delete Transactions

1) Select the transactions to be deleted

2) Click on the

Delete

DXM menu button illustrated opposite.

3) Tick the box to permanently delete the transaction, or leave unticked to only mark as deleted - later re-restorable if required. Click

OK

Select transactions by status:

All Items

Waiting

Errors

Deleted

Select by date range.

Click the

Period

box first then select date range

Select by name of file used to transmit the data.

Select by name of Dr. who requested the data

Select by

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Select by name of person who imported the data.

Select by

Patient name

Transaction

Selector

Column

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Creating a Definition File

To create a DXM definition file:

1) Click on the Data Exchange Module Receive Box button on the

HEALTH

one

TM

toolbar.

The definitions window appears with the current definitions listed.

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2) Click on the

New

button.

The definition file wizard starts and screen one appears:

3) Click

Next

DXM Definition File Wizard - Screen 1

Type the name of the laboratory here.

Select the collection service type here,

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Select here the laboratory you are collecting from. Contact

HEALTH

one

if it is not in this list.

Enter here the location on the receiving computer where the collected data can be found.

Type here the mask which will filter out just data sent from this laboratory.

The laboratory will provide this information.

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Creating a Definition File

To create a DXM definition file:

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4) Click

Next

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5) Click

Next

There is now a further patient filtering screen which can be bypassed.

6) Click

Next

DXM Definition File Wizard - Screen 2

Options

Choose here what is to be done with the original lab information once it has have been imported.

Choose here whether the imported information should be integrated immediately into the patient‟s file or left in the Data

Exchange Inbox awaiting validation by the GP before integration.

Choose here how un-matched patient‟s data should be managed. See

managing DXM

Errors

earlier in this section.

DXM Definition File Wizard - Screen 3

Advanced Options

There are a number of options on this screen, two of which are described here.

If a patient was marked as

not found

and later matched to an existing patient. Future mis-

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If this definition is collecting data via email the email subject content should be specified here.

Only matching emails with this subject will be extracted from the email in-box

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Creating a Definition File

To create a DXM definition file:

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7) Click Finish

The wizard closes and the new definition appears in the list.

Lab Display Styles

These display styles are optional and were designed specifically for the

HSE South

East (display original lab codes), and Health link (display fixed width font). They are both accessed by clicking on the main menu :

Tools

Options

data Exchange module

We have two new options here:

Lab transactions now can display the lab code and lab description by option. The

HEALTH

one

TM

code remains mapped in the DXM mapping if there is a mapping.

Below is a screen shot of a lab result as seen in a patients record in

HEALTH

one

TM

:

The display opposite is seen if you have ticked the « display original codes » button above. The text displayed is taken directly from the lab message. You can at any time switch back to « normal display », below.

Schedule

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If this definition is to run on a regular basis it can be set to automatically occur according to the schedule defined on this screen.

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.

Network Configuration Sharing

Introduction

A

configuration

is a collection of data such as sequences, aggregates, templates and general user settings. Each installation of HEALTH

one

TM

has its own

configuration

set, which equates therefore on a network to each user having their own set.

While this allows for individual preferences many users would like ONE common configuration set for all users.

There are two ways in which HEALTH

one

TM

allows this common network set to be managed:

one

TM

the network configuration set is selected.

Note: Once a configuration set has been selected it will remain the active set for future logons until changed. when required. Typically all changes are made to the network configuration set and all users synchronise to this when required.

Normally one or other of the above methods is chosen but not both.

Method One

– Selecting a Configuration Set at Logon.

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Technique

1) Start HEALTH

one

TM

and when the logon screen opens click on the

Advanced

tick box.

A configuration tab appears.

2) Click on the

Configuration

tab to bring it forward. set.

3) Click on the

Add

button.

4) In the

Browse for Folder

window locate the network configuration set

(usually on the server

…\Honewin\Config

). Click

OK

.

The server configuration location is added to the configuration tab.

5) Select the server configuration and click on

Select

. Click on the

Sources

tab and logon in the usual way.

Note:

The

Configuration

tab will now remain as a feature of the logon screen. In the event of the network failing, or a laptop not connected to the network, the

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LOCAL configuration can be selected when required.

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Network Configuration Sharing

Method Two

– Synchronising Configurations

Technique

1) Start HEALTH

one

TM

2) Click on the

Synchronise Configurations

button on the standard toolbar.

Illustrated opposite.

3) The

Define the synchronisation

window appears. Click the

New

button.

4) Type a description for the destination source being synchronised with in the

Key

box.

5) Click on the browse button to the right of the

Destination config directory

box.

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The Browse for Folder window appears.

6) In the

Browse for Folder

window locate the network configuration set (usually on the server

…\Honewin\Config

). Click

OK

.

The config and drug directory boxes are completed.

7) To synchronise, now or in the future, ensure the

key

required is selected and click on

Synchronise

button.

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Synchronising Sources

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Introduction

A source contains a complete set of information regarding a practice, including patient files, billing information, appointment information and user information. Many practices will have secondary sources such as a laptop source, RIP Source and possibly a backup source somewhere on the network. These secondary sources need to be kept in-sync with the master source on the server.

How a source is created is documented in the

Installation Guide

and is normally performed at installation time. There are two types of source:

Master

and

Slave

and dependent upon the type(s) being synchronised various options will/will not be available.

Regardless of source type the procedure is quite straightforward.

Synchronisation Technique

1) Start HEALTH

one

TM

and login to ONE OF THE SOURCES TO BE

SYNCRONISED.

2) Click on the

Synchronise Sources

button on the Standard Toolbar.

Illustrated opposite.

The Synchronisation Wizard start.

There now follows a series of screens the first of which is just an opening screen and can be by-passed in the future by ticking the

Do not display…

box

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3) Click

Next

.

You can now opt to synchronise just those

selected in the patient selector

, ideal for synchronising one or two patients, or archiving deceased patients

– or - scan

all patients using common options

for a certain match, i.e.

all patients changed since

….

4) Choose the type of selection method. Click

Next

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Synchronisation Technique

This screen is where the destination source is selected.

6) Click on the

Select Source

button.

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Once the source has been selected the direct of synchronisation can be chosen.

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Typically in the case of a laptop the direction of synchronisation when

leaving

the practice would be

Server to Laptop

and when

returning

Laptop to Server

. There is also an option to synchronise in both directions

– , naturally, this would take longer to perform. The option to

Compact

a source before synchronisation compresses the source and reduces its size.

We recommend that this option be set.

6) Choose the direction of transfer and compaction required. Click

Next

.

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Synchronisation Technique

The next screen controls

what

is to be synchronised. The options available here will vary dependent upon the types,

slave

or

Master

, of sources being synchronised. The screen below is configured to just synchronise patient files

(HCR‟s).

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Options

a)

Synchronise HCR’s

Patient Files b)

Don’t /Do synchronise deleted..

Patient‟s deleted in one source can optionally be deleted in the destination source. c)

Advanced (Archive..)

This option is for archiving files, for example if deceased patient‟s are being synchronised to an RIP source.

Options control what will happen to the files in the original once synchronised to the destination.

Don’t delete…

Files left intact.

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Delete HCR…

Moves patient files to the deleted patient selector screen.

Delete permanently…

Permanently delete the files in the original source. d)

Audit trail

Only applicable for Slave/Master synchronisations

– synchronises the audit log. e)

User information

Only applicable for Slave/Master synchronisations

–Changes in Master

Source users

– i.e. new users, password changes, rights changes etc. f)

Billing

Billing information. g)

Appointments

Appointment information.

7) Choose what is to be synchronised. Click

Next

or

Finished

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Synchronisation Technique

The screens that appear next are dependent upon the

What

is being synchronised as per the previous screen.

HCR Synchronisation

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8) Choose HCR settings. Click

Next

or

Finished

Billing Synchronisation

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9) Choose BILLING settings. Click

Next

or

Finished

Options

Select to update patient files that have changed since the last update

…and enter a date and time.. or leave unchecked to synchronise all patients.

To synchronise for just a particular doctor/user select here and choose the user here

Options

Delete records…..

Destination billing records deleted if they have been deleted in the original source

Options

Select to update billing information changed since the last update …and

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To synchronise for just a particular doctor/user select here. and choose the user here

If

non existing patient

box is ticked billing information for a missing patient in the destination source will cause the entire HCR for that patient to be synchronised.

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Synchronisation Technique

Appointments Synchronisation

Note:

This applies to legacy appointments only.

In order to synchronise appointments, you must be logged into

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9) Choose APPOINTMENT settings. Click

Next

or

Finished

All the settings have now been specified and the final screen will appear to confirm.

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10) Click

Finish

to synchronise or

Cancel

to abandon.

Options

Select to update appointment information changed since the last update …and enter a date and time.

To synchronise for just a particular doctor/user select here. and choose the user here

If

non existing patient

box is ticked appointment information for a missing patient in the destination source will cause the entire HCR for that patient to be

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Problem Orientated Medical Records

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Keeping Problem Orientated Medical Records

HEALTH

one

has a feature called

Problem Orientated Medical Records

(POMR) which provides the ability to link transactions to a problem. Once linked in this way the physician can firstly, see at a glance what the patient‟s primary problems are, and additionally elect to view only those transactions that relate to a particular problem.

Problems appear in the

Problems Tab

of the

Patient Information Panel

.

This tab has two buttons

– one to display the active problems and the other to display the historical ones.

POMR

is an extension to the transaction filtering method mentioned in the

Getting Started

section. There it was described how to filter the

Transaction Panel

to view just lab results, experts reports etc. Once POMR is implemented, it is possible to view lab results that just relate to a particular problem.

The process of using the POMR feature is as follows:

Declare a problem

Link transactions to a problem

View transactions relating to a specific problem

Change the status of a problem between active and inactive

Displaying / Hiding the Problem Tab

The Problem Tab is displayed or hidden in the

Patient

Information Panel

by selecting the menu option

View

/

Problem

Declaring a Problem

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Problems are declared by inserting the item

problem:

into the patient‟s file. This could be inserted into any transaction, however; we suggest that it be inserted into the Basic Medical

Information page

– i.e. the first page in the medical chapter. The reason for this is that it provides a consistent method/location for recording problems and will make them easier to locate when updating is required.

The standard process of creating a new patients file is to create a Basic

Medical Information transaction as the first transaction in the Medical Chapter

– this is done using the Sequence

Basic medical information

– this sequence includes the item

problem:

.

Technique

1) Open the patient‟s file and select the

Basic Medical Information

transaction

– first one in the medical chapter.

2) If the item

problem:

exists already select it and press

Return

. Go to step 6)

Create the item

problem:

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Declaring a Problem ..continued

3) Select the last item (do not open it)

– this is done to ensure that the

problem:

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4) Click on the

Insert Item

button on the Item Panel Toolbar

– illustrated opposite.

The Item Selector opens

5) Type:

prob

into the Find box and select the item

problem

in the list.

Click

OK

The problem item is inserted into the Basic Medical Information page and automatically opens; displaying it‟s associated list.

6) Select the problem required in the associated list, or alternatively close the list and type the problem yourself

– we would recommend that the terms dictionary

(blue book button) is used to ensure that the problem is correctly entered

– rather than just type it.

7) The date the problem started/ended now needs to be recorded. If the

Item attributes are not in view click on the button illustrated to view them now.

In the

fig. 3-1

below

hypertension

is being used as an example problem and the item attributes are in view:

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3-1

Enter the date the problem started here

When the problem ends, tick this box and complete the

End date

.

This will cause the problem to move from the

Active

to the

History

view of the

Problem Tab.

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Declaring a Problem ..continued

8) If you are declaring a new problem enter the problem

Start date

no need to type the // marks.

Do not confuse the

Date of event

date with the

Start date

. The

Date of event

date is the date on which the

problem:

item was inserted into the file

(usually today‟s date) and the

Start date

is the date the problem started

– this could be some years earlier.

9) Save and validate the Basic Medical Information transaction.

The problem now appears in the active problem window of the

Problem Panel.

Linking a Transaction to a Problem

A problem must first be declared as described above before it can be linked to a transaction.

Linking a New Transaction

Whenever you insert a new medical transaction into a patient‟s file

HEALTH

one

displays its properties window.

Problem

is one of the attributes in the transaction properties window and all the declared problems for the current patient are displayed there.

Fig. 3-2 shows how the properties window may appear for a patient that has a number of problems declared:

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1) Click on the box opposite the problem to be linked to place a tick inside it.

2) Complete the rest of the transaction properties and click

OK

.

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Linking an Existing Transaction

To link a previously created transaction to a problem you need to view its attributes by opening its properties window. To do that:

1) Open the patient‟s file and click once on the transaction in the

Transaction

Panel to select it.

2) Click on the attributes button on the Transaction Panel Toolbar.

The properties window now appears

3) Click on the box opposite the problem to be linked to place a tick inside it.

4) Close the properties window and save and validate the transaction.

Viewing a Transaction Related to a Problem

1) Click once on the required problem in the Problem Tab.

2) Click once on the

Transaction

Panel

to make it active. Hold down the

Ctrl

key and press

E

The Transaction Panel now only displays the transaction related to the selected problem.

3) You can switch problems while you are in problem view by clicking on a different one in the

Problem Tab.

The Transaction Panel now only displays the

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4) To return to normal view Hold down the

Ctrl

key and press

E

once again.

Transaction attributes button

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Viewing a Transaction Related to a Problem ..continued

There is an alternative way to switch between problem view and normal view:

1) Click once on the required problem in the Problem Tab.

2)

Right

click the mouse anywhere in the Transaction Panel and select

Filtered on problems

in the pop up menu that appears.

The Transaction Panel now only displays the transaction related to the selected problem.

3) To return to normal view repeat step 2) above.

Changing the Status of a Problem

A problem can have one of two states: Active or Inactive. This is controlled by the

End date

check box in the

problem:

items attributes. Refer back to fig.

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3-1.

To Make a Problem Inactive

1) Open the patien t‟s file and click once on the transaction that contains the

problem:

item. If you took our advice this will be the

Basic Medical Information transaction.

2) Click once to select the

problem:

item. Press

Return

to open the item.

3) Now check the

End date

check box and complete the end date.

4) Click

OK

to close the item window. Save and validate the transaction.

Problem now appears in the History view of the Problem Tab.

To Make an Inactive Problem Active

1) Follow steps 1) and 2) above, now uncheck the

End date

, follow step 4)

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Own Notes

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5.1

Billing

Page 2 of 10

Billing

Concepts

The Billing feature of HEALTH

one

TM

allows charges for services/products in the practice to levied against patients and payments recorded. Patient Invoices and receipts can be printed along with reports which reflect the current state of the practice accounts.

Acts

HEALTH

one

TM

considers each individual charge in a practice as a billable

act

. When a patient receives medical services and/or products these are charged by inserting the relevant

act,

with a record of its cost, payment and receipt status, into the patients file. In cases where an individual service involves several charges a

calling act

is created.

Invoices and Receipts & Payments

Invoices can be produced for one, some or all outstanding charges for a patient. When a

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Toolbar enabling a receipt to be issued if required.

Reports

The population analysis has a number of reports under the

billing

heading of the Database

Analyses. These produce figures in detailed and summary form on a patient, doctor or debtor basis.

Family Billing

The easiest way to bill a family is to post sibling and spouse charges to the head of family patient account - entering a relevant comment describing the charge reason.

Debtors

The Debtors function is designed as an enhancement to the reporting system allowing individual patient charges to be assigned to a third party - such as a health insurance company or individual company for occupational health.

The Billing Panel

Acts

are billed and payments recorded in the Billing Panel. This panel occupies the same place on the screen as the Item Panel. Switching between them is a simple process of selecting the relevant tab.

Scope of this Document

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This document describes the technique of implementing the Billing system on an individual patient basis using single charge

acts

and producing invoices, receipts and reports for same.

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5.1

Billing

Page 3 of 10

Billing Panel Tab Outstanding balance value for this patient

Creating Billing Acts

The steps involved in implementing and using the Billing feature are:

Create / Maintain the billable

acts

Charge

acts

to a patients account - issue invoice/receipt

Record payment and issue a receipt

Print Billing Reports

Creating an Act

The first step in implementing the billing facility of HEALTH

one

TM

is to create the various charges that apply within the practice - each chargeable item/service is considered as an

act

.

The approach to this is: practice.

Create an

act

for the individual charges.

Technique - To create an

act

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1) Open any patients file. (The Billing feature in accessed from within a patient's file.)

2) Click on the

Billing Panel

tab, above the Item Panel, to reveal the

Billing

Panel. There may or may not be an outstanding balance value displayed

- dependent upon the billing options settings. See

Billing Options

later in this techniques section.

The Billing Panel now appears. See below

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3-3

Insert Delete Print Print Act Debtors Filter Active Filter an

act

an

act

Receipt Invoice Editor Editor Selector Description

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5.1

Billing

Page 4 of 10

Creating an Act

3) Click on the

Act Editor

button on the Billing Panel Toolbar. See fig. 3-

3 above.

Act Editor window appears.

The Act Editor and its acts are available to all patients.

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4) Select the menu

File / New Cost Item

, or press

Ins

key, or click on the

Create new cost item

button on the Act Editor toolbar.

A new Act appears in the Act Panel and prompts for a description.

5) Type the

Description

of the act. Enter the

Cost

(charge) for the act. If the

Doctor price

for the act is different enter it in the

Doctor price

. If the

Doctor price

is left blank the

Cost

price will apply. Leave the

Active

box checked. If billing is being synchronised between different sources, i.e. server and laptop, leave the

To synchronise

box checked.

6) Click once on the Edit/Select button to the left of the new act. Click

OK

to save changes when prompted. Repeat 4) - 6) to create remaining charges.

Select then menu

File / Close

to close the Act Editor window.

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Create a Save Delete Create Create Delete Delete new cost current current a calling a called a calling a called item (

act

)

actact act act act act

Acts Panel

Calling Acts

Panel Called Acts Panel

Edit / Select

Button

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5.1

Billing

Page 5 of 10

Setting the Default Act

The

Default Act

automatically appears whenever a new charge is inserted into a patient's file. The ideal choice would be the most common type of act, for example

consultation

.

The default act can be overwritten with any other when it is not correct.

This is to save administration time.

1) Click on the

Act Editor

button on the Billing Panel Toolbar. See fig. 3-

3 above

2) In the Act Panel select the Act to be set as the default by clicking once on its

Edit/Select button. Now select the menu

Option / Default act

.

The selected act now appears in bold in the Act Panel.

Amending Acts

From time to time it may be necessary to amend the details of an act, for example when costs get reviewed.

1) Click on the

Act Editor

button on the Billing Panel Toolbar.

Act Editor window appears.

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2) Locate the

act

to be edited - if there are many acts use the search box: type sufficient text of the

act

description to find the one you require.

List of acts synchronises with the text typed in the Search box.

3) Amend the

act

details as required.

4) Click once on the Edit/Select button to the left of the new act. Click

OK

to save changes when prompted.

5) Select the menu

File / Close

to close the Act Editor window.

Charging Acts to a Patient's Account

1) Open the patients file.

2) Click on the

Billing Panel

tab, above the Item Panel, to reveal the

Billing

Panel.

The Billing Panel now appears. See fig. 3-3

3) Click on the

Insert Act

button or press the

Insert

key.

A new act appears in the Billing Panel. If you had set a default act

(see above) its description and charge are automatically entered.

See fig 3-4 below

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Charging Acts to a Patient's Account

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4) If the default

act

is the one you require - press the

Right Arrow

cursor key to move to the next box of the

act

and alter/amend as required.

5) If the default act is not required press the backspace key to delete its description. Now type the description of the

act

you do require, or use the

Up

and

Down Arrow

cursor keys to sequentially display all the available acts.

When the

act

required is located press the

Right Arrow

cursor key to move to the next box of the

act

and alter/amend as required.

6) Use the

Right

and

Left Arrow

cursor keys to navigate through the act.

Complete the various boxes as follows:

Cost

If a

Doctors price

had been set up for the selected act its value will appear here, if not, the cost value will appear. Delete to replace with a different charge.

Paid

If the patient is paying immediately enter the amount here. If the value entered is equal to the cost the

Status

box will automatically become 'checked'.

Status

This box represents the paid status of the

act

. This will automatically become 'checked' when the payment amount is equal to the cost amount. Whenever this charge is to be considered 'paid' this box should be

'checked'.

Debtor

If the charge is to be billed to a third party - like a health insurance company - the name of the company is entered here. Create debtors via the

Debtors Editor

.

See Fig 3-3.

Receipt

If a receipt has been issued for this charge click on this box to 'check' it.

Doctor

This drop down box lists all physicians in the practice.

By default it will select the logged on Doctor/User.

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Comments

This is a free text box for any comments.

Synchronise

In instances where a practice is in more than one location this box indicates that the charges should be moved/synchronised between them.

7) Once the charges and payments have been entered as required the

act

must be saved. Click once on the Edit/Select button to the left of the new act.

Click

OK

to save changes when prompted.

8) If Invoices/Receipts are to be issued do so now (see below) otherwise save the patient's file.

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Page 7 of 10

Printing Receipts and Invoices

Payments/Receipts

When a patient pays for an

act

, either immediately or sometime later, this should be entered in the

Paid

box of the

act

. As soon as a payment is entered the receipt button on the Billing Panel Toolbar will activate. Click on it to print the receipt.

Select

Receipt35.CVS

and click

Open

. The receipt will appear for previewing.

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To print the receipt select the menu

File / Print

or use the short cut

Ctrl

+ P

Click also the act

Receipt

box to indicate that a receipt has been taken for this

act

.

Invoices

If an invoice is to be issued for all

act

s click on the invoice button on the

Billing

Panel Toolbar. Select

Bill35.CVS

and click

Open

. The invoice will appear for previewing.

To print the invoice select the menu

File / Print

or use the short cut

Ctrl

+ P

If an invoice is to be printed for a specific

act

or

acts

hold down the

Ctrl

key and

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act

to be invoiced to select it.

Edit / Select

Button

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5.1

Billing

Page 8 of 10

Invoices

Now, hold down the

Shift

key and press

F8

or alternatively,

Right

Mouse

click on one of the selected

acts

and select

Invoice selected acts

from the pop up menu.

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Select

Bill35.CVS

and click

Open

. The invoice will appear for previewing.

To print the invoice select the menu

File / Print

or use the short cut

Ctrl

+ P

Entering Payments

1) Click on the

Filter

button on the Billing Panel Toolbar and select

Unpaidacts

from the drop down menu.

2) Enter the amount in the

Paid

box of each act being paid. Note: if the payment had previously been part paid enter the complete paid amount.

3) Print receipts if required (see above).

4) Check the

Receipt

box of the

act

/

acts

affected.

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Billing Techniques

Printing Reports

The Population Analyses - Database Analyses module includes reports

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Billing feature.

These are available in detailed or summary form by Patient, Doctor or

Debtor.

1) Click on the Population Analysis Button on the HEALTH

one

TM

Analysis

Toolbar.

2) Click on the Database Analyses Tab.

3) Click on

Billing

to view the billing analyses reports.

4) Select the report you require and click on the

Execute

button.

The selected report window opens

5) Select the date range for the report or the

Last number of days

as required.

Click on the

Execute

button to run the analyses.

Results appear in tabular form.

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6) Click on the

Printer

button to preview and print the report.

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Own Notes

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5.1

Managing Patient Files

Page 2 of 5

Managing Patient Files

This section describes the techniques of deleting, synchronising, exporting and importing patient files.

Deleting Patient Files

HEALTH

one

moves files in the

Patient Selector

window to the

Deleted

Patient Selector

window. The deleted patient files can be viewed in the

Deleted Patient

Selector

. If files are subsequently deleted from the

Deleted Patient Selector

window they will be deleted permanently

Deleted patients can be restored from the

Deleted Patient Selector

back to

the Patient

Selector

in cases where they have been deleted in error.

Deleting A Patient File

Locate the patient in the Patient Selector

Select the patient (do not open the file) by clicking once on the patients name. Press the

Delete

key. Answer

OK

when prompted.

Alternatively, select the

Delete

Patient Selector button at the bottom of the screen.

Patient removed from the Patient Selector window.

Viewing Deleted Patient Files

Right

click anywhere in the Patient Selector and select

Show deleted patients

from the menu.

Deleted Patient Selector appears.

Deleted patient files can not be opened - if this is necessary, restore the file to the active Patient Selector. See next topic.

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Re-Viewing Active Patient Files

Right

click anywhere in the Deleted Patient Selector and select

Show active patients

from the menu.

Active Patient Selector re-appears.

Restoring Deleted Patient Files

Select the patient file in the

Deleted Patient Selector

Click on the

Restore

Patient Selector button at the bottom of the screen. Answer

OK

when prompted.

Permanently Deleting a Patient File

Select the patient in the

Deleted Patient Selector

Click on the

Delete

Patient

Selector button at the bottom of the screen.

Answer

Yes

when prompted.

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5.1

Managing Patient Files

Page 3 of 5

Managing Patient Files

Synchronising Patient Files

In practices that have laptop computers and/or more than one geographical location it will be necessary to keep different sources

synchronised

together. HEALTH

one

provides a wizard to make this a straight forward task.

Firstly, both sources must have been

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one

™.

The subscribing of sources is part of the installation procedure. See session eleven for details on this.

Secondly, you must have the rights to perform this action - if not see your system administrator.

1) Login to anyone of the sources to be synchronised

2) If you wish to synchronise only selected patients - select them now in the

Patient Selector.

3) Click on the Synchronisation Wizard button on the HEALTH

one

toolbar.

The Synchronisation Wizard window appears.

4) The first screen is just informative - click

Next

The next Wizard window appears

5) The next screen prompts to synchronise the

all

or

selected

patients - choose whatever is appropriate. Click

Next

The next Wizard window appears

6) Click on the

Select Source

button and login to the source to be synchronised with.

The wizard window should now have two sources declared. Firstly, the one you initially logged on to and secondly the one you just selected. See fig 10.13

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5.1

Managing Patient Files

Page 4 of 5

Managing Patient Files

Synchronising Patient Files

7) Select the direction of synchronisation or select both directions as required.

See fig. 10.13 . Click on

Next

The next Wizard windows appears

HEALTH

one

enables just certain types of information to be synchronised if required, for example just Clinical Data(HCR) or Billing Data or

Appointment

Information etc. The next screen of the wizard enables these to be selected.

8) Select the information to be synchronised. Click

Next

The next Wizard windows appears

The next window of the wizard enables data to be synchronised by date and time -

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(if left un-checked all records will be synchronised regardless of date or time) and for all or a single user.

9) Select the date/time settings as required.

10) Select the User or All Users (leave un-checked) as required.

11) Click

Next

. When the final screen appears click

Finish

.

Fig. 10.13 Synchronisation Wizard

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5.1

Managing Patient Files

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Managing Patient Files

Synchronising Patient Files

12) At the end of the synchronisation you can optionally view details or simply click

OK

to finish.

Fig. 10.14 Synchronisation End Dialogue Box

After synchronisation in both directions

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5.1

Vaccination Techniques Page 2 of 15

Vaccination Techniques

Introduction

HEALTH

one

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has a number of features which aid the recording and

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Allowing batch numbers and expiry dates to be edited as well as new vaccines to be added.

one

TM automatically tracks for due dates and received vaccinations from the date of birth. childhood vaccinations schedule.

The Patient Information Panel has a tab dedicated to vaccinations.

Overdue vaccinations appear in red and automatically activate this tab causing it to appear in front of the others.

The Patient Information Panel opposite shows four vaccinations have been missed and are overdue.

Due dates are automatically calculated from the child‟s date of birth.

Recording Non Scheduled Vaccinations

The following method is used to record all vaccinations unless a

childhood vaccination schedule

is being used. In cases where a schedule is being used for childhood vaccinations the method

ChildhoodVaccination Schedules

, documented later, should be

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Technique

– Recording a Vaccination

1) Open the patient‟s file and add (click on the stethoscope icon) a new medical transaction with a

Type

equal to

Contact

and the

Name

set to

vaccination

.

A new medical transaction is inserted into the patients file.

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Technique

– Recording a Vaccination

2) Insert the sequence (

Shift + F4

)

Vaccine

into the new transaction.

3) Ensure the item

vaccine:

is selected and press

Return

Item Vaccine: now opens and also its associated list.

Note:Upgrading Users

The associated list appearing for the item

vaccine:

is retained for compatibility with previous methods

– however; we recommend that it is

NOT

used, but rather select the vaccine from the new

Vaccine

Database

as described below.

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4) Close the

Associated List

box.

5) Click on the

Vaccine Button

to open the vaccination database.

Alternatively use the short cut Ctrl

+ Alt + V

The vaccination database window opens

6) Enter text into a filter box. In Fig. 3-23 the HEALTH

one

TM

term

typhoid

(V)

has been used, however, the vaccine(s) could equally have been filtered by

Vaccine Name, Manufacturer

or

Batch Number

by entering text into their respective filter boxes.

7) Locate the vaccine and select it. Click

OK

The vaccine details are entered into the item vaccine PLUS the item attributes are also set to their correct values. See Fig. 3-24

Vaccination Database Window

– Filtered for typhoid vaccines

3-23

Vaccine Button

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Technique

– Recording a Vaccination

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Note:

The item

vaccine:

values for

Dose

,

Site

,

Manufacturer

,

Batch number

and

Expiry date

are extracted from the vaccine database. They can be adjusted to correct any changes for this particular vaccination.

If the

Batch Number

is amended a prompt will appear to request if the vaccine database should also be updated.

By preference the Batch Number and

Expiry Date should be changed by configuring the vaccination database.

See the heading

Maintaining the Vaccination Database

later in this section.

Vaccine Item

– Attributes automatically set the values of the selected vaccine.

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Technique

– Recording a Vaccination

8) Correct the item attribute values if required. Click

OK

to close the item.

The vaccination details are recorded in the current transaction and also appear

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Patient Information Panel.

Specifying Recall Dates

If childhood schedules are not being used the method of specifying a recall date utilises the item

Plan of action:

If schedules are being used this procedure is NOT required.

The

Vaccine

sequence includes the item

Plan of action:

and this will also be present (refer back to Fig. 3-22) in the current transaction.

1) If the item

plan of action:

is not present in the current transaction insert it now, by clicking on the

Insert Item Button

on the item panel toolbar.

2) Ensure that

plan of action:

item is selected and press

Return

to activate it.

3) Select

vaccine

from the associated list.

Note:

The object here is to place the word

vaccine

into the

plan of action:

item

– not to re-state the type of vaccine

– that has already been done in the item

vaccine:

4) Cancel the associated list box.

5) In the

plan of action:

item details check the

Date of event

box and enter the

RECALL date required.

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6) Click

OK

to close the

plane of action:

item.

The recall date has now been specified. This child will now be detected by the population analysis reports designed for childhood vaccination reporting.

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Childhood Vaccination Schedules

HEALTH

one

TM

has a scheduling feature designed to manage childhood vaccinations. There are two phases involved:

Assignment

This phase is repeated once for each child. It places the aggregate item

vaccination schedule:

into the child‟s file and links the timing schedule to it.

Recording

This phase is repeated for each vaccination

– recording its details:

date

,

vaccination name

,

batch number

,

expiry date

etc.

Note:

Users that are upgrading from an earlier version will first need to create the aggregate item

Vaccination schedule:

Refer now to the heading

Techniques for

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Upgrading Users

further on in this section.

Assignment Phase

– Insert the Schedule into the Child’s File

A child being presented for vaccination is assigned a

Schedule

by inserting the aggregate item

vaccination schedule:

into the Basic Medical Information transaction. Once inserted the timing is activated by linking the schedule to a timing set of rules and selecting the child‟s date of birth.

Technique

– Insert the Schedule into the Child’s File

1) Open the child‟s patient file.

2) Select the Basic Medical Information transaction.

3) Open the aggregate item selector by using the short cut

Shift + F5

.

4) Select the aggregate group

Vaccination schedule

and click

OK

transaction.

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Assignment Phase

– Insert the Schedule into the Child’s File

Technique

– Activate the Schedule Timing

5)

Right Click

on the

Vaccination Schedule:

item and select

Apply

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vaccination schedule:

Vaccinations

from the pop up menu.

A prompt appears with the child‟s date of birth

6) Click

yes

when the prompt appears.

The schedule is activated appears in the Vaccine tab of the Patient

Information panel.

See Fig. 3-25

Recording Phase

– Recording Vaccinations using the Schedule

This process is repeated for each vaccination a child receives.

The vaccine schedule appears in the Vaccine tab of the Patient

Information Panel. Fig. 3-25

The vaccination schedule lists the type of vaccination required at a given due date based on the child‟s date of birth. Each vaccination type is linked to a particular vaccine or vaccines in the vaccination database.

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Technique

–To record a vaccine:

1) Create a new medical transaction

Type

=

Contact

and

Name

=

vaccination

2) Click on the

Vaccine

tab of the Patient Information Panel to bring it into view.

3) Click ONCE on the vaccination that is being received this time to select it.

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Technique

–To record a vaccine:

4) Click on the injection needle icon on the

Vaccine

tab toolbar (see Fig.

3-25) or use the short cut

Ctrl + Alt + V

What happens next is dependent upon how many vaccines are in the

Vaccine Database

for the selected vaccination type. If only one vaccine exists this will be issued immediately with its name, today‟s date, batch number, expiry date etc – Go straight to step 6). If more than one vaccine exists the vaccine database window will open, displaying all matching vaccines

– Go to step 5).

5) When the

Vaccine Database

window opens

– choose the vaccine being administered this time. Click

OK

A new item vaccine: appears in the current transaction displaying the vaccination details.

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6) Check the vaccination details. If necessary amend the details by highlighting the item

vaccine:

and pressing return. Click

OK

to close the details.

Note:

The item

vaccine:

values for

Dose

,

Site

,

Manufacturer

,

Batch number

and

Expiry date

are extracted from the vaccine database. They can be adjusted to correct any changes for this particular vaccination.

If the

Batch Number

is amended a prompt will appear to request if the vaccine database should also be updated.

By preference the Batch Number and

Expiry Date should be changed by configuring the vaccination database.

See the heading

Maintaining the Vaccination Database

later in this section.

Information

Panel is also updated.

7) Repeat actions 2)

– 6) for any other vaccinations being administered at this time.

Manufacturer Dose Site Batch No. Expiry Date Count

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Changing the Scheduled Due Date of a Vaccination for

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a Child

There may be instances where it is known that a due date for a vaccination will be missed, i.e. due to a holiday etc. To prevent HEALTH

one

TM

reporting this as overdue the due date can be altered:

Technique

1) Locate the vaccination concerned in the

Vaccine

tab of the Patient

Information

Panel.

Double Click

the vaccination.

The transaction that contains the schedule opens and the selected vaccination is shown in a dotted box.

2)

Right Click

the vaccination in the dotted box and select

Shift Vaccination due date

from the pop-up menu.

A prompt box appears to request information about the new due date.

3) Complete the prompt box by typing a number and selecting the Day,

Week,

Month etc from the drop down selection box.

Due date changes for the selected vaccination.

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Note: If a number of vaccinations are to be moved select them all before right clicking. All selected vaccinations will have their due date altered in the one operation.

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Vaccination Techniques Page 10 of 15

Managing Vaccination Refusals

The method of recording a vaccine refusal depends upon how the vaccination is being recorded.

Not using a vaccination schedule and specifying the refusal directly in the

vaccine:

item.

New method

Using the Childhood vaccination schedule.

Former Method

If childhood vaccinations are being individually recorded the technique is:

1) Open the patient‟s file and add a new medical transaction with a

Type

equal to

Contact

and the

Name

set to

vaccination

.

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2) Insert the sequence (

Shift + F4

)

Vaccine

into the new transaction.

3) Ensure the item

vaccine:

is selected and press

Return

Item Vaccine: now opens and also its associated list.

4) Locate the tern

refusal

in the

Associated List

box. Click on the

Insert

button.

The term refusal now appears in the vaccine content box.

Note:

DO NOT type anything else in the item content box (i.e. the name of the refused vaccination) because HEALTH

one

TM

only reports those items with a

sole content

of the word

refusal

as being refused. The vaccination name is entered in the item comments box.

5) If necessary click the

expand

button to view the item attributes.

Check the

Date of event

box and type the name of the vaccination refused in the comment box. Click OK to save item.

6) Right click on the item and select

Display / Comments

from the pop up menu.

New Method

If a childhood vaccination schedule is being used:

1) Select the refused vaccination in the

Vaccine

tab of the Patient

Information Panel.

2) Click on the

Refusal

button on the Vaccine

Tab toolbar

Refusal Reporting

See next heading

Childhood Vaccination

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Recalling/Reporting

.

Refusal Button

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Childhood Vaccination

– Recalling/Reporting

The population analysis reporting is used to produce reports regarding childhood vaccinations. The choice of report depends on the method used:

Not using a vaccination schedule and specifying the recall date in the

plan of action:

item.

New method

Using the Childhood vaccination schedule.

Technique

1) Close and save any open patient files

2) Select the menu

Analysis /

Population analysis

.

(Short cut =

Shift+F7

)

3) Click on the

Database

Analysis

tab.

4) Expand the

Vaccines

section.

5) Select and Execute reports as required

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Reports for the Former method

If you are using the former method of recording childhood vaccines use the following report to list those patients who have an overdue vaccination:

Planned Vaccines (Plan of Action)

Reports for the New method

If you are using the new schedule method of recording childhood vaccines use the following report to list those patients who have an overdue vaccination:

Planned Vaccines (Due Dates)

Overdue vaccine

Reports for the Either Method

Regardless of what method is being used the following reports are applicable:

Patient’s with a vaccine between two dates

Vaccines Monthly

– All together

Vaccines Monthly

– All together (Per child)

Vaccines Monthly

– History per child

Vaccines No Record

Vaccines Refusals

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Maintaining the Vaccine Database

The vaccination database will need to be updated whenever a new batch of vaccines is received or a vaccine is released on to the market.

Opening the Vaccine Database

1) Click on the

Vaccine

tab of the Patient Information Panel for any patient.

2) Click on the

Configure

button on the tool bar (see Fig. 3-26)

Changing Batch and Expiry Dates

1) Locate the vaccine to be edited by typing its name in the

VaccineName

filter box, or if known, type the old batch number in the

Batch Number

filter box.

2) Once the vaccine has been located edit the old data. i.e. batch number details, expiry date etc.

3) Click the tick box to save your changes. See Fig. 3-26

4) Click the

Close

button to close the vaccine database window.

Adding a New Vaccine

1) Open the Vaccine database as outlined above

2) Click on the

Plus

button (see Fig. 3-26).

A new blank line appears at the end of the database.

3) Select the vaccine type from the HEALTH

one

TM

term drop down box that this vaccine belongs to (i.e. Influenza [V]).

4) HEALTH

one

TM

automatically offers the type as the name for the vaccine, simply select this and type the actual name. Complete the other details.

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5) Click the tick box to save your changes. See Fig. 3-26

6) Click the

Close

button to close the vaccine database window.

Filters

New Vaccine Plus Tool Accept Changes Tick

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5.1

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Techniques for Upgrading Users

Create the aggregate item Vaccination Schedule and Timing

Schedule

This action is performed only once and creates the aggregate item

vaccination schedule:

containing the current list of childhood vaccinations. In conjunction with this a

timing schedule

(set of rules) is declared that states when the vaccinations should occur with respect to the child‟s date of birth.

Technique

– Create the Vaccination Schedule Item

1) Exit the HEALTH

one

TM

program.

2) If there is a RED HEALTH

one

TM

icon on your desktop double click it to launch the configuration tool. Alternatively select the menu

Start /

Programs /

HEALTH

one

TM

/

HEALTH

one

TM

Tools

/ Configuration Tool

.

3) When the logon screen appears log in as you would for

HEALTH

one

TM

.

Note:

The configuration tool is used to control many of the features within

HEALTH

one

TM

and is documented in a separate manual. For this reason

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4) Select the menu

File / Open / Aggregate

or use the short cut

Shift +

F5

The aggregate item screen appears. This has its own toolbar.

5) Click on the last button on the right of the aggregate tool bar (see Fig.

3-27)

The aggregate item is now created and also its timing schedule.

6) Select the menu

File / Exit

and click

yes

to save changes when prompted.

The Configuration Tool closes.

3-27

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Linking Existing Vaccinations to a Schedule

Upgrading users will have a number of child patients that have already received some childhood vaccinations at the time of the upgrade. These vaccinations will appear as independent entries in the

Vaccine

tab of the Patient Information Panel.

If the child is under a year old we recommend that a vaccination schedule is also included, those vaccines already administered will appear as

overdue

as far as the schedule is concerned

– because their entry in the schedule will be blank.

This problem is overcome by linking the existing vaccinations received to their corresponding entries in the vaccination schedule.

Technique

1) Insert a schedule as detailed in the procedure

Assignment

Phase

– Insert the Schedule into the Child’s File

above and activate the timing schedule.

The Schedule now appears in the Vaccine tab with a number of vaccinations in RED indicating that they are overdue.

2) Double click on the EXISTING vaccination to be linked to the schedule.

The transaction that contains the vaccination is opened and the vaccination highlighted by a dotted box

3) Ensure the EXISTING vaccination is still selected (dotted box around it)

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Vaccine

tab, that it is to be linked to.

The link icon on the Vaccine tab will activate. See Fig 3-27

4) Click on the link icon (see Fig. 3-27).

The link occurs and the scheduled vaccination is marked as completed and turns black in colour.

5) Repeat for other vaccinations that require linking

3-27

Existing Childhood Vaccinations

Existing vaccination.

Scheduled vaccination to be linked to.

Link icon

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Vaccine item displayed with vaccine grid

We can automatically have the item « vaccine » display the vaccine grid.

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To do this you have to open the configuration tool

– click on the button

Click on File open item

Type in the term « vaccine » and change its entry style to « vaccine »

Now the grid opens automatically when you call the item “vaccine”.

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Introduction

The « plan of action » concept allows you to plan an action or a series of actions for a patient. In this way your patient can benefit from a prevention schema which helps you with the follow up of the patient.

In Ireland, using 3.7 and earlier version we used the item attribute « Date of event » as a planning date. Thus when a patient had a cervical smear done we would add the item

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« plan of action » with the content = cervical smear and edit the « date of event » to a date, say 3 years into the future. We would then be able to recall these patients via our population analyses.

THE OLD WAY

In 5.0 we use a slightly different way of entering the due date for a planned action. This new way allows a much greater flexibility in viewing our planned actions and setting alerts for actions that are, for example, overdue or nearly due.

THE NEW WAY

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As you can see from this screenshot you can specify several things about this plan of action

1. Planned date for the action :

Here you can enter either the exact date you want the action to be done or a time interval when it should be done, say in 3 years time.

2. The

frequency

of the action to be carried out there after. You use this only if

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will then automatically ask you do you want to carry on with the plan when the number is up.

3. Whether you require a

reminder

to appear in the patient file when you open the record

4. Who is

responsible

for carrying out the plan

5. What

item name

you would like to use when you declare the action as being done.

These are all configurable

Now when you open the patient file all her planned actions are visible in a new tab next to the billing tab in the medical section of the file

This is how the item will be entered in the patient file

And when you click on this tab you see a list of planned actions for this patient :

You can also plan an action using any item in HEALTH

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If the item

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Combination Keys

CTRL+L

.

Viewing the action plans :

A. In the individual patient record

You can click on the action plan tab and see any actions that have been planned. These can be filtered by clicking on the filter button as below

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B. Viewing the Action Plans for the entire patient population

We now have a new tab in the patient selector called the « action plan » tab

If you click on the action plan tab you are presented immediately with all the actions planned for the entire patient population :

You now have many options open to you to filter the list according to various criteria. For example ;

Planned date

: if you click on the down arrow in the planned date column you can see that

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In fact, this filter is very powerful. You can use, not only the options in the provided menu, but you can insert dates with mathematical syntax e.g.

Show me all actions planned between 01/01/2006 and 31/03/2006

>01/01/2006 <31/03/2006 (note there is a space before each operator)

The syntax for the filter is as follows

Choose a single month (Ex : 06) or a particular year (Ex :2006)

You can use the greater than and less than operators as above

> and <. (Ex : >2005 < 07/2005, >01/2005 <2006, …)

You should play around with this to get some interesting results.

Item Content :

This is self explanatory. You can filter the list to show all cervical smears or all abnormal lab results that came in today and are due to be done my me.

Note

: You can send a mail merge letter to patients on this list by using the new mail Merge function. This is described separately.

You can, with version 5.0 insert a plan of action directly into a lab result as it appears in the DXM inbox (see later).

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When a planned action is done ?

Now you have a list of planned actions in the action plan tab for the entire population and also, possibly, a list of planned actions in each patients file, visible when you click the action plan tab.

When you actually carry out these plans, how do you manage the plan.

There are several ways of doing this. However, in Ireland we advise you to stick with the following protocol.

1. Individual patients :

If an action is planned, there will appear in the patient record, an additional tab called « action plan ». This tab contains a list of all the planned actions.

You can click on one of the buttons at the top of the action plan tab, or right click on the action plan to get a list of possible actions. One of these is to

« set the action as done »

Setting the plan as « done » will remove the plan from the list in the patient file and also from the population list. An item will be inserted in the medical section to say the action is done. What item you use will depend on the options you set in the tools\options\action plan\ menu. By default the item name will be « done » and the content will be the name of the action :

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You will also, of course, have to enter the result in the normal manner.

For example, if a smear comes back, you will enter the item « cervical smear » with the result as the content.

In the case of a lab test you will enter the item name and the result, unless the result is imported electronically when it will be added in the same way - haemoglobin A1 --- 7.8

NOTE :

If you do not set the plan as done it will continue to appear in the list of planned actions and will soon make the list worthless.

Prevention Module

The prevention module consists of two parts

1. A user defined list of action plans known as a

prevention template

2. An

Alert

that be triggered in the patient file and is user configurable.

The

Prevention Templates

are a series of planned examinations i.e.

protocols

that allow you to follow the evolution of a particular patient pathology, e.g. diabetes.

This is something like a sequence but is linked to the plan of action and the alert functions.

An

Alert

is a notice which can be automatically triggered by certain information contained within the patient record. For example, if a patient has the item

« problem » with the content = « diabetes » you can trigger an alert which tells you the patient is diabetic. It is then possible to link this alert to a prevention template such that, not only does the alert tell you the patient is diabetic, but may also suggest that you put a series of planned actions, automatically in the patient record but only if the prevention template has not already been added.

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Creating a prevention template

When you need to do certain tests/examinations/investigations on a regular basis, you can organise them into prevention templates by using the configuration tool.

The mechanism is similar to the use of the vaccination templates used for planning childhood vaccinations.

Each action plan can have a date attached which HEALTH

one

will remember and alert you, if you wish, when it is due.

1) Open the configuration tool with the button

Click the icon (manage prevention templates).

The prevention template window opens

2) In the list of templates window on the left, click the button

+

to add a new template

Insert the name you wish to give the template e.g. « diabetic protocol ».

The name of the template appears in red next to a pencil icon

3) Now click on the pencil icon and the name is saved and changes from red to black

4) Now click the

+

icon at the bottom of the right hand window « content of the selected template» . A new window appears :

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As you can see, some of the boxes are filled in already with default contents. These contents are defined by the user in the main

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toolbar menu tools\options\action plan. In this case the next planned date is 3 years, the frequency is 3 years and the item name HEALTH

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will use when you set an action plan as done, will be « done »

5) Now you complete the fields as you please.

- Item name: Select an item from the list (usually « plan of action »)

-

Content

: Add a description in free text

-

Planned date

: define the date the action should be done or the time interval

-

Frequency

: If the action should be repeated, tick the box and define the interval. You can also enter the number of times the action should be repeated.

-

Reminder

: Here you can enter when you want a pop up reminder to appear e.g. 2 weeks before the action plan is due.

6) Repeat the procedure above for each plan of action you require for this prevention template

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Inserting the prevention template to the patient record

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1) Open the patient file and create a new transaction

2) Use the main HEALTH

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menu (Insert\prevention template)

3) Alternatively you can click on the icon

4) On the left you can see the name of the templates, on the right the action plans that have been defined. Select a template and click OK

The template appears in the patient file as follows :

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Alarm or Notification

Whenever an action is planned, HEALTH

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will notify you when you open the patient record. You can choose the various ways you can be notified in the options menu.

Open the options dialogue from the main HEALTH

one

menu

(Tools\options\Alert tab).

Here you can define the way you want the alerts to behave when activated

A notification in the HCR may appear

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The Action plan tab in the patient file may be selected by default

And you can have it play a sound if you wish !

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Carrying out your action plans

HEALTH

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offers you two ways to indicate that an action plan is done.

In the action plan tab in the patient file you can directly edit the status of an action so as to show which actions are done and which are not.

Click on the down arrow to display the possibilities

Or in the medical section, select an action plan, use the right click to display the contextual menu or simply hit the Combination keys (Ctrl+Q).

A window opens where you will decide the date of the action and the name of the item used to save the action plan. The defaults are defined in tools\options.

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To indicate that the action is done, a new item ( the action item) is entered to the transaction : he name of the item has been defined in the configuration tool but may be changed here.

A new plan of action may be entered here also, automatically, depending on the setting you decided in the configuration tool when defining the prevention template.

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The Alerts

An Alert is a notification in the patient file which is triggered by defining certain criteria. The alerts are configured by the user and consist of a message which is displayed when an automatically launched analysis produces a result (or by option does not produce a result).

The alerts are defined in the configuration tool as follows :

Open the HEALTH

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configuration tool.

Click the button to display a list of the alerts. (You may also use the menu item file\open\alerts).

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The list on the left shows the details of the alert. The list on the right shows the list of prevention templates which may be linked to a specific alert on the left.

The alerts that are invalid (for example the analysis corresponding to the alert does not exist) are displayed in red. Only the valid alerts can be triggered.

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Defining an Alert

You can add, edit or delete an alert with the appropriate buttons at the bottom of the list of alerts (see previous screen shot. « + », « - » and . You can also use the

Combination

Keys : Ins, Ctrl+D et Crtl+E.

Click on the to create a new alert.

Click the « enabled » box to enable the alert.

Give a name to the alert. This will be displayed in the notification.

Choose an analysis from the list. The analyses that are available are those created in

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: They are taken from those analyses available from the main HEALTH

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menu

Analysis-formulas-extraction formulas

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Some « System » analyses are included in the list as well as the extraction analyses. For example, « patients birthday ». The system analysis are placed at the end of the list.

Tick the « result » box if the alert should be triggered when the analysis gives a result.

Un-tick the « result » box if the alert should be triggered when the analysis gives no result.

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Triggers : These options allow you to decide under what circumstances the alerts should be triggered.

Manually by the user : The analysis is not executed until you click on the menu item tools

.

During the Update of the HCR : With each modification of the

HCR, the analysis will be executed.

On opening the patient file: The analysis will be executed when the file is opened

On closing the patient file: The analysis will not be executed until the file is closed.

Insert a message in your own language. You can translate this into several

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Note:

*

The result of the analysis is

not used,

only the presence or absence of a result is taken into account.

Let‟s take a few examples

Example 1

: Patient‟s birthday

1) Click the button to create a new alert

2) Complete the information

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Example 2

: The patient has never had his weight checked?

1) Click the button to create anew alert

2) Fill in the boxes

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Linking a prevention template to an alert

In the configuration tool alert window, you can link (or un link) an alert to a prevention template by clicking on the « + » and « - » below the list of templates via the right click

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Within the patient file you can search for a prevention template after clicking on the button shown below.

The prevention template selection dialogue appears :

Triggering of the Alerts

The alerts may be triggered either manually, on opening the patient file, after editing the file, on closing the file ; or manually by the user at any time by clicking the menu tools\trigger alerts or by using the Combination Keys Shift-Ctrl-F4.

The alerts may be displayed by several means within HEALTH

one

™.

1. A sound may be emitted

2. A written notice may be displayed in the patient file. A simple click in this notice will make the alert go away.

3. A button appears in the patient file, on the far right of the top of the medical side.

4. The list of alerts may be displayed automatically.

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Looking at the Alerts

Click on the bell button in the patient file or use the Combination Keys

Ctrl-Alt-A

A dialogue appears containing the list of alerts

When you close the dialogue, the alerts are considered as read and do not appear the next time you open the file, unless you declare otherwise by un-ticking the «

Hide read alerts ».

In this case the read alerts will be in

italics

to differentiate them from unread alerts :

The button allows you to deactivate an alert. In this case this alert will not appear for any patient file in the future. You can re-activate the alert by going into the configuration tool alert function (see above).

The button allows you to manually insert, from within the alert notice, a prevention template linked to an alert. If however a prevention template is not linked to the alert, this button will not appear in the alert notice. When you click on this button, a menu appears from where you choose from a list of prevention templates. You can choose one or all of the templates. The templates already inserted and the invalid templates will be greyed out and you will be unable to insert them.

Note:

If all the templates linked to an alert have already been inserted to

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Options

The Plan of Action functions may be customised in the options menu

– main HEALTH

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menu tools\Options\Action Plan

Default values

:

Default Frequency: The frequency with which the actions are repeated

Default realisation item : The item name used to indicate that an action is done

Use the plan of Action item as the realisation item : Use the same item name to indicate that an action is done as is used for the planning. end

Display

: in the vaccination schedules appear in the action plan tab in the patient file

– but not in the action plan tab of the selector. you can display all un read transaction in the action plan tab.

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Ask to create an action plan in not today‟s transaction : If you make an action « done » in an older transaction you will receive a confirmation dialogue.

Display a dialogue when an action is done : Display a confirmation dialogue when you declare an action as done.

Automatically select today‟s transaction for the action plan : If this is ticked, the action plan is automatically put into today‟s transaction, if it exists.

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Initialise the « Un read » status (for the following items):

unread » status

Import of HEALTH

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HCR‟s : If you import a patient file, all its transactions will be tagged as « un-read »

Synchronised transactions : Appear as un-read if ticked.

Reminders

: do you want the reminder to be triggered action plan tab » - « whenever a reminder is to be displayed », then when you open HEALTH

one

the action plan tab is automatically displayed, instead of the medical section tab.

Analysis :

the action plans for the logged on user are displayed in the action plan tab of the selector by default.

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Own Notes

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Queries: Extraction of Data

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Introduction

The Query Plus module provides a simple yet powerful method to extract data from a population of patients based on user specified criteria. Furthermore, the query results can be combined with one another to provide added flexibility.

Query Plus is based on the same concepts as the medical record. There are three levels:

Patient

,

transaction

and

items

. You can specify criteria at each level.

For example provide a list of all females, older than 60 years (Patient, Sex=female,

Age>=60), that were seen in the last 12 months that have received a flu vaccination.

Patient

Sex=female

Age>=60

Transaction

Date>01/01/2005

Item

Vaccine, content, contains, flu

With Query Plus, you can select multiple items. You can also exclude patients that have an item containing a particular (or any) content.

1) Open the module Population Analysis. Select the menu

Population analysis

.

2) Normally the tab “Database analysis” will be immediately visible

3) The last item in the menu is “User analysis”

Note

: This screen can be directly accessed from the main HEALTH

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4) Click on “New” and the following window appears.

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Population Analysis Criteria Window

1) Enter a description for the query in the “Analysis name” box and a description for the category group in the “Group” box.

2) The various options to create your query are divided into sections:

Patient Criteria

Transaction criteria

Item Inclusion criteria

Item Exclusion Criteria

Restrict to another analysis

3) Each of the sections has tick boxes to the left of the criteria. These determine whether the indicated field will be displayed in the result or not.

4) Now we will deal with each of these sections in detail

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Patient Criteria

From this section, we can choose to search from any or all of the three criteria Age, Sex, and Display

1)

Age

– We can choose patient of a given age, an age between X and

Y, Greater than (>) X or Less than (<) Y.

We can choose here whether to display the age in the final result or not by ticking the box.

2)

Sex

– Choose either all, male or female.

3)

Display

– Here we decide what fields we want to display in the result.

The choices made here will always display as well as those fields you may tick in relation to specific fields that you otherwise choose in your analysis.

The Possible fields that you can display here are those available in the patient selector.

In this particular analysis, we are making no choices from the patient criteria. Therefore we are choosing all our patients as a base for the extracting our information

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Transaction Criteria

1)

Chapter:

- Here we can choose between Administrative Chapter and

Medical

Chapter. This criterion is rarely necessary and should generally be ignored!

2)

Date:

- here we can choose between

all transactions

, transactions done

after

a particular date (greater than), transactions done

before

a particular date

(Less than) or transactions

between

two dates.

You specify the dates in the columns to the right of the screen

3)

Type:

- Here we can choose the name of the transaction as displayed when creating a new transaction in HEALTH

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In our current analysis, we will leave all these fields empty. Thus, we want to include all transactions in the patient files, no matter when they were done or what name we gave them

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Item Inclusion Criteria

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In this section, we have the opportunity to include up to four items in the search. Thus, each row in this section corresponds to one item. Each column represents the possible options with each item

1. The tick box column is used to decide if the item name and content will be displayed in the result or not. Tick the box to display the item and its content.

2. The

item name

is entered in the second column. You can choose here from any

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item

3. The

Item Content

column. Here you can choose from several attributes of the item, namely the

main content, sub contact, or item codes.

Normally you will use only the main content here.

4. The

fourth, “Contains”

column, is used to declare several possibilities in regards to the content. These include whether the item

contains, is equal to, is greater than, is less than etc, or even if the content exists at all.

Open the options with the drop down list to see for yourself what the possibilities are.

5. In the fifth

“Contents”

column, you should say what content it is that you are looking for.

If you are looking for several contents of the same item, as in our vioxx case, you can enter all the required contents to the one “contents” box. Each content should be separated from the other by a semi-colon (;). Other mathematical operators that can be used are as follows:

Replace the item name with a star (*), if you are looking for a content of

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Use the hash sign (#), to search for a numerical or date value

Note:

In our example, we are looking for all patients who have a repeat prescription for either of the drugs “Vioxx” or “Ceoxx”. We could have used two rows in the “item inclusion” section to achieve this. However, using the one row with the semicolon separator is more efficient.

6. The

“AND”

and the

“OR”

boxes at the top of the screen are used to declare whether each row is taken. Thus if we use th e “OR” box we are saying that the search will give a result if either of the search conditions listed in the first two rows

(above) are true. If we say “AND” then both criteria must be true to give a result.

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Item Exclusion Criteria

This section is based on exactly the same principles as the previous section “Item Inclusion

Criteria”. You use the same methods for entering,

item name, contents, content parameters and actual item content.

However, any information included in this section will be

excluded

from the search.

Thus, we might ask the question: Give me a list of all diabetes patients in the practice who

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“diabetes” would be included in the “Item Inclusion” section, but the item name “weight” would be included in the

“Item exclusion” criteria. Therefore, everyone who is a diabetic is included and then everyone in this list who has a weight recorded would be

excluded

.

Note:

In the above example the “item inclusion criteria” section is governed by the

“OR”

parameter. Therefore, if any of the three criteria are true we will get a result.

In the case of the “Item exclusion criteria” section, as there is only one field included, it does not matter whether we use the “AND” or the “OR” parameter. The “AND” and “”OR” parameters are used

within

each section and have no relevance

between

sections.

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Restrict to Another analysis

This section is an additional tool, which adds power to the original

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In the example above you can, for example, make you first analysis to execute and then to

exclude

patients found as a result of a second analysis, say, exclude those patients on glucophage, avandia or diamicron!

However, this section is most often useful when we use the “include” criterion.

Here are two examples of how it is best used: a) You create one analysis to include many items: You create a second analysis that excludes many things. You add the second an alysis in the “Restrict to another analysis” section of the first analysis. b) You might want to use the second analysis to simplify the query. Let us say you want to create an analysis to find all diabetic patients who have a

BMI >

30: Create a first analysis to find all your diabetic patients; create a second analysis to find all patients with a BMI > 30. You can restrict the first analysis to the second.

You might use this method when the two analyses are useful in their own right.

It will save duplication.

THE ANALYSIS RESULT

Let us return to the “Vioxx” analysis:

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This analysis should give us a list of all our patients who have a repeat prescription containing either Vioxx or Ceoxx. The result will display the patient surname, first name, sex and DOB. It will also display the “repeat Prescription” item and its content.

1) You can execute this analysis directly from this screen by clicking on

“execute”.

Alternatively, you can save this analysis by clicking OK. Click OK

2) You are presented with the list of all the user-defined analysis with your newly created analysis included in this list.

3) Within this screen, you have the options as displayed.

E

x

ecute the analysis (Alt+X)

E

dit the highlighted analysis (Alt+E)

Create a

N

ew analysis (Alt+N)

D

elete the highlighted analysis (Alt+D)

4) Click on “execute”

As you can see, we found four patients who have, in their repeat prescriptions, either Vioxx

or

Ceoxx.

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What can we now do with the result of this analysis?

HEALTH

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‟s Data Ware House (DWH) “Query Plus” is a very

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one

TM

and contain most of the common, day to day analyses needed by the busy professional.

With the result of the “Query Plus” analysis we have a new range of options.

1) We can simply Print the result

– Click on the print Icon

2) We can copy the result to the windows clip board

From here, we can easily “paste” the contents into Microsoft Excel, for example.

3) We can export the result to a CSV file

This again can be imported by other programs such as excel

4) We can insert a “Plan of Action” into each of the patient files included in the result. This is indeed very powerful. We can then see at a glance from the patient selector all these patients. We can initiate an “alert” when we open the patient file which will remind us of the situation. Details of the “Plan of action” function are described elsewhere.

5) We can send a personalised letter to each of the patient in the result, asking them, for example, to contact the doctor for an alternative treatment. We would use the “Mail Merge” function in HEALTH

one

TM

to do this. This function is described elsewhere but essentially involves creating a document template, within HEALTH

one

TM

, with the require message for the patients and including some “mail Merge” fields which would personalise the letter for each of the recipients.

This template might also contain an internal “HCR analysis” that will extract

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TM

will first load all the patients found by the population analysis and then perform the

HCR analysis before finally displaying all the letters on screen, for printing.

Note:

Mail Merge is only available with the DWH Query Plus, when executing the analysis from the main database analysis window. It is not available from the DWH

Query Plus

edit window

.

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Creating a mail merge letter to all patients found as a result of a DWH

Query Plus analysis

1) Having performed the DWH analysis as described above, you should select all the records in the result with your mouse.

2) Click on the Mail Merge Icon

– you are asked to choose the document template.

3) The document will be executed for each of the selected records. Each letter, in this instance will have a personalised greeting

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Creating an Action Plan for all the selected patients

1) Perform the analysis as described

2) Select all the patients with your mouse

3) Click on the Action Plan Icon as indicated above.

4) Fill in the various fields as indicated and Click OK

Note:

Here you can choose a) The name of the responsible person to carry out the Plan of action b) Whether you want an alert to be triggered when the patient file is opened

This is the result in the action plan tab of the Patient Selector

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Own Notes

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Mail Merging in

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one

TM

HEALTH

one

document templates normally extract various bits of information from the patient file. We often extract single administrative items such as the patient‟s first name, surname etc, or we can extract other data such as the medical history/surgical history, last consultation etc, by means of “HCR analyses”

This type of data is extracted when we create a letter from an individual patients file and is

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Mail Merging

– what is it?

Mail Merge gives us the ability to achieve three different things:

1)

Using Database files (DBF or Access) to enter consultants names to standard templates

Include the name and/or address of the consultant that we are referring to at the top of the letter, say the quicklet. We are including this function here because it is a prerequisite for the second function. However this function does not in fact use the specialized “Mail Merge” fields included in the HEALTH

one

text editor

2) Send a

personalised letter

, generated by HEALTH

one

for an individual patient, to

several recipients or destinations

. Thus we might want to send a quicklet for John Test to two consultants who are dealing with the patient.

3) Send a

personalised letter to several patients

about the same thing. For example we may want to find all males over the age of 50 and if they have not had a cholesterol check, we might want to send a letter to each of these patients.

Each letter can be personalised so that we use the correct “mode of address” for example. Dear Mr. Test, Dear Ms. Burke etc.

The first two of these functions require the use of an external database containing a list of,

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Honewin\DBF directory.

As these databases are localised they are not distributed with

HEALTH

one

. It is possible to create a database by following the steps below.

Creating Database files (DBF files)

1) Click on the button « manage associated databases » on the main toolbar in

HEALTH

one

2) Click on the button « new table » on the right of the

« database query » window

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Creating Database files (DBF files)

Below is a sample database we have just created:

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Using Database files (DBF) to enter Consultant’s names to letters

In most normal situations when you are sending a letter to a specialist, you will not, in fact need to use the Mail merge facility. This would only be used if sending the same letter to several destinations. However, you would often want to insert the name of the specialist into the executed document. HEALTH

one

gives you this facility.

First of all you need to have a database containing the details of all the consultants in your area. These do not come as standard with HEALTH

one

! However, some users have already created these databases in particular localities

– enquire from the user group.

It is relatively easy to create DBF 111 file from an excel spreadsheet.

Many people will keep a list of their local hospitals/consultants in this format. We cannot describe this process here.

Once you have a dbf (or access) file with the names and details of the consultants you refer your patients to, you should save them to the directory honewin\dbf of your current

HEALTH

one

configuration.

The following procedure assumes you have a dbf file in the honewin\dbf directory :

1) Click on the main HEALTH

one

menu File\Open\Template

2) Choose an existing template as an example, say Quicklet.cvs

3) We will now enter a DBF field in the location indicated in the screen shot

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Using Database files (DBF) to enter Consultant’s names to letters

4) Click on the button « insert text blocks {field} » -The following window appears

5) Choose the DBF file that you require, containing the list of all the consultants in your area. Then Click on the « choose fields » tab.

This window allows you to choose the fields that will automatically be inserted to the final document when you execute it and choose your consultant

– see below.

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Using Database files (DBF) to enter Consultant’s names to letters

6) You choose the field name and then click the

+

key to copy it into the top window.

You can add free text e.g. a space between fields using the « insert text

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» box. In this example we are going to add the consultants title, first name and surname to the executed document in the place indicated above.

7) Click OK

8) Now click

file\save as

and name the template = « Quicklet_DBF.cvs »

9) Now open a patient file, if not already open. Press Shift+F2 or click on the cogwheel icon to execute the template « Quicklet_DBF.cvs »

10) You are immediately presented with a window containing the

list

of the consultants.

You only job now is to choose a consultant and click

apply.

11) The Title, first name and surname of the consultant will appear in the letter.

12) Note that you can always at the final stage choose your own fields to be entered in the final document by manually selecting the fields in the above screen shot and clicking « inset » to insert each field. This was the only way to do things in previous version of HEALTH

one

TM

but it is cumbersome.

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Creation of a template and send it to several destinations

Insertion of the mail shot fields

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To create a template that you want to send to several places follow the procedure described below :

1) From the main HEALTH

one

TM

file menu, choose File\New\Template

2) Arrange the text and place the cursor where you want to insert a field

3) Click the button to insert a mail merge field or use the HotKey

Combination

Shift + Ctrl + Q. This button is the third button from the right in the toolbar of the canevas editor.

4) Choose external database as the source. The external databases should be located in the directory honewin\dbf.

If you want to use an MS access database you should also choose the table that contains the fields you require,

5) The dialogue displays the available fields in the selected database.

Simply select the field you require and press the OK button. If you require more than one field press « insert ».

The Mail Merge fields are entered to the template as - {MailMerge :

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6) Repeat the operation to add more fields. Only one external file is used, you can‟t change the database file to insert a second field.

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Note:

You can always change the format of the field, for example the font, colour etc.

Inserting the field « Carbon Copy »

When sending a letter to several people, it might be good practice to include all the recipients as

« CC »

. This can be done easily.

Click on the down arrow next to the Mail Merge icon and choose « Insert carbon Copy field.

Double click on the fields you want to include in the carbon copy field.

You can also add free text here.

Click OK.

The formula above contains the consultants name and Hospital.

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Insertion of destination field to the patient file

HEALTH

one

can remember the names of the people that the letter was sent to and save this information into the patient file

To do this you must add a « destinator » field, available in the same drop down menu.

As with the CC field, you add the fields you require into the « destinator » field and click OK.

Note:

The destinator fields are used only when saving the letter to the patient file.

They are deleted from the document during the merge.

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Inserting analysis fields

This is exactly the same as inserting an analysis in any document template. It allows you to extract some data from the patient file for the document.

Saving your work

Your template is now ready, save it.

Here is an example of a template, including the mail merge fields, and analysis extractions

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Sending a letter to several destinations

1) Open the patient file

2) Click on the template execution button (Shift + F2)

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3) Select a Mail Merge template that you want to use. On opening the template all the HCR analyses will be executed

with the exception of the Mail

Merge analyses

.

4) Select the Mail Merge button in the top tool bar of the template editor.

This is the second last button on the top toolbar of the template editor.

5) The database that you choose when entering the Mail Merge fields is opened.

You choose, from this list the addresses you want to send the letter to.

You can double click on the name in the bottom panel to send it to the top

(selected) panel.

In this list you can select the name of the destination from the bottom grid

« All records ». Press Enter or double click on the name to select.

The selected destinations appear in the top grid. You can remove a selected name by using the right mouse click.

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Sending a letter to several destinations cont.

6) Click OK to execute the template, one for each destination..

7) To Archive the document in the current transaction of the patient file click and select « in HCR as multimedia object »

You get the same dialogue if you close the executed document directly by using the top right hand X of the text editor or by using the Combination keys

Ctrl+F4

8) Select the item name with which you want to save the document

Note :

You can set a default item name to store archived documents, by using the main menu tools\Options\Template

9) You can change the name of the document, add a comment, add a severity index so it appears in red in the file or make it « display protected » so that nobody except the person who created the document can view the document.

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Sending a letter to several destinations cont.

The document is saved in the patient file. To open it from there you should double click it.

If the template contained the field « destinator » these names will be saved to the patient file also under the item « document sent to »

Note:

Please remember that when you execute a mail merge template the « Mail

Merge » fields will not be immediately executed. You have to click on the

« merge » button

after executing the template

.

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Sending a mailing to a selection of patients

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You can choose the recipients for your letter from several lists within

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one

The Patient selector

The « Action Plan » tab in the patient selector

The result window of a DWH analysis

The relevant billing summaries

In this example we will do a DWH analysis to find all males over 50 who have not had a cholesterol check in the past 12 months. The details of creating DWH analyses are described elsewhere ; This is the DWH screen with the analysis defined :

Click on execute and you get this :

Now we can highlight this list and send a letter to each of them, personalised.

Click the highlighted button and each of these patients gets a plan of action automatically.

You can now create a Mail Merge Document from the « Action Plan » tab in the

Patient Selector. (You can also do this directly from the DWH analysis result screen !)

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Click on the Mail Merge Button on the bottom of the patient selector screen.

Choose your mail Merge letter as you have already created.

A letter is shown, one for each patient in the list with the correct salutations, for example, and is ready for printing.

Working with a Dictaphone:

The doctor working with a Dictaphone may have to slightly modify his diction to be understood. It is much easier to pronounce the recipients at the end of the session.

1) Click on the icon to execute a template ( = shift + F2)

2) Choose the template that you wish to execute. All the analyses are executed

except

the Mail Merge analyses that appear in the text editor window.

3) Type the letter from the Dictaphone

4) Choose the merge button again from the toolbar at the top of the text editor window. i.

Select the destinations from this list as above.

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Options

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In the main menu bar of HEALTH

one

select Tools\Options and then select the

« template » tab. It is here that we can define various options relating to templates and Mail

Merging.

Template Selection

important in a network environment where, if a someone makes a change to a template, or creates anew template, it will not be available to others unless they all have the same path entered here.

Archived Document

a document to the patient file. Use this option in order to avoid being asked for a name every time you archive a document close the editor after archiving.

Mail Merge

You can define the number of copies of the first page to be printed.

Printer Configuration

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Own Notes

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Patient Selector - Age

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Version 5.0 has added two new fields that can be viewed

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Patient

AGE

Patient category

Patient age:

Viewing the patient age will give you significant advantages when filtering patients from the patient selector.

To view the patient age, or any other available filed, in the patient selector, you should click on the « configure » button at the bottom of the patient selector screen.

At the bottom of the resulting list is the « patient age » field. Tick this.

Likewise, you can add the field « patient category » to the columns of fields available in the patient selector. See the paragraph about the new « GMS editor » to see the value of using the patient category.

Using this column you can immediately select patients of any age, less than any age, greater than any age or between two ages. Use the following operators :

>,

<,

>xx >yy

Note the syntax here ; >xx(space)<yy. Think of this as « greater than(=>)XX

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AND (=space) <(=<)YY

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GMS Editor

We have a new concept of the GMS number for 5.0. In this version you are encouraged to enter

only valid GMS numbers

to the item « GMS number ». We use the item « patient category » to display which category the patient belongs to : for example, GMS, GMS DVC (

D

octor

V

isit

C

ard), PP, Visitor, Temp, etc.

The two items are linked in HEALTH

one

TM

such that when you edit one, you are compelled to edit the other.

If you create a new patient and enter the item « GMS number », you will be presented with the following screen.

If the patient is a GMS patient, or a GMS

DVC patient (see drop down list), you will be able to enter a valid GMS number.

Otherwise the GMS number box will not be available for data entry

Below is some of the list of patient categories available by default :

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This list is defined in a DBF (database) file which is delivered with

HEALTH

one

TM

.

This means it comes by default with all new installations. However, you can add to this list by clicking on the little edit box next to the drop down list as in the screen shot above. This is described later.

The name of this DBF file is « GMSEditor.MDB ». It will normally be located in the shared configuration directory\set1\dbf directory. If you are not using a shared configuration (no network), then it will be in c:\Honewin\DBF directory.

The advantages of this system is that the GMS number is used solely for the purpose it was designed for ; you can see at a glance from the patient selector, your list of GMS patients, DVC patients PP‟s etc. by using the « patient category » column.

Existing HEALTH

one

TM

users who are upgrading to version 5.0 or 5.1 may, if they wish, convert all their records to the new system. To do this you need to use the

HCR Edit Tool

– see the 5.0 manual for details.

Note:

The use of the GMS editor function is optional ! Click on tools/options to see the possibilities. If it is unchecked, then the GMS number and patient category become un-linked.

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GMS Number Editor

– converting 3.7 records

Users of all previous versions of HEALTH

one

TM

have always been using the item « GMS number » to record not only all valid GMS numbers, but also all patient categories such as

PP, visitor, NHS etc.

HEALTH

one

TM

version 5.0 introduces a link between the item « GMS number » and the item

« patient category ». This is described above. Here we describe the method of converting all your 3.7 patients to the new system.

HEALTH

one

TM

comes with a very useful tool called the « HCR Edit Tool

». This tool can be used to change things in all your patient files in one go. One of these is to examine the contents of the item « GMS number ». If this item contains a valid GMS number it leaves the item alone and adds a new item called « patient category » with the content « GMS ».

Thus every GMS patient will have two items as follows

GMS Number is retained if existing number is valid.

Patient category item is added

If, however, the GMS number item contained a value other than a valid

GMS number,

HEALTH

one

TM

moves the content of the item to the new item « patient category ».

NB:

The contents, if any, of an existing item « patient category » will be deleted.

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GMS Number is removed.

Contents of GMS no. Moved to patient category item.

Using the HCR Edit Tool:

Click on the windows start menu and then all programs

– HEALTH

one

TM

5.0

– HEALTH

one

TM

Tools

– HCR Edit

Tool. You are then asked to log in to the relevant source - do this. You are presented with a screen with several options

Choose the option « Update GMS numbers ». The next screen will ask you to confirm your choice. Remember that all your patient files will be changed. This has implications for the next time you synchronise! The process will take time, up to an hour if you have 10,000 patients

.

The result will change both the items « GMS number » and

« patient category » as shown

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Some new features in the patient file:

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If you open a patient record you can see the following new icons/features available in version 5.0:

1. Direct insertion of a Basic Medical transaction

2. View family records

3. Refer transaction

4. Insert prevention template

5. Display all the patient data in chronological order

1. Direct insertion of a Basic Medical transaction

This is a quick way of entering a new BMI transaction. Simply click on the button next to the « new transaction » button on the left hand side of the open patient record screen, or hit the Hot Key Combination Ctrl+J

2. View family records

This feature allows you to bring up a list of family members when you have a patient file open. For this feature to work you must, of course, have given each of the members of the family a number by entering the number in the admin page in the item « family number »

When you click on this button you can see a list of all members of the family:

This screen gives you several possibilities:

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3. Refer transaction

This function is only available if you use the « Multi user Appointments ».

Multi User appointments are described elsewhere. However, it is enabled by checking the relevant box in the HEALTH

one

TM

main menu item tools

– options – appointments.

You can refer the current transaction to another team member by clicking on the « refer transaction » icon on the toolbar at the top of the right hand panel of the medical section of the open patient record.

When you click on this icon the following dialogue box opens:

Now double click on the recipient - a further dialogue will appear:

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When you click on « save and exit », you return to the patient file. The message then appears in the multi user appointments messages section, in Dr. Mary‟s inbox. When

Dr. Mary sees the message she can go directly to the patient file and the relevant transaction, with one key stroke.

4. Insert prevention template

The use of the prevention module, including prevention templates, is described in the section on «action plan»

However, you can insert a prevention template at any time, from within the patient record by clicking on the icon on the toolbar at the top of the right hand panel of the medical section of the open patient record.

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When you click on this icon the following dialogue box opens:

The actual prevention templates are user defined and can be created in the configuration tool. This process is described in the section on the «action plan»

5. Display all the patient data in chronological order

This is an extremely useful new function in HEALTH

one

TM

version 5.0.

It allows you to view the patient‟s entire file in one « page » that you can

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You can easily search all the data for any text you like.

You can access this feature by clicking on the icon « display all data in chronological order » which is on the main HEALTH

one

TM

toolbar:

When you click on this icon you are presented with the following screen:

You can now search all the data in the patient record simply by typing some text in the search box:

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You will see all the instances of the searched for text including the dates involved. This can be extremely useful for finding any information you wish in the patient‟s file.

6. Transaction Naming

HEALTH

one

TM

has always used an associated list with the « transaction name » to distinguish between different types of transaction. For example, consultation, visit at home, drug prescription, obstetrics, lab…

This list is created in the configuration tool.

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Open the configuration tool. Click on <file

– open – transaction name> or use the Hot

Key combination « Ctrl+T »

The screen below is the normal dialogue presented when you are adding terms to the list of « transaction names ». However the check box « show all terms » is new to

HEALTH

one

TM

version 5.0.

If this check box is ticked you have access to all the HEALTH

one

TM

items and contents for use as an associated list to the « transaction name », when creating a new transaction for a patient.

7. Transaction Comment

Furthermore, we now have a new transaction attribute that we can use to extend the naming of transactions.

Every transaction now has a new attribute called « transaction comment

». This attribute allows flexibility if you want to have additional methods of filtering the list of transactions in the left hand panel of the patient record. We might use the « transaction comment » field if we want to use other clinical information, not available in the list attached to « transaction name »

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If you organise yourself you can have an intelligent list of things you might put in this window that allows you to see at a glance additional information relating to each consultation by using the transaction filter.

In the transaction view above we have added a comment to 4 transactions

Haemoglobin, ECG, 24 hr BP monitor and Dexa scan. We can now filter the transactions on, for example, dexa scans, so that we can more easily look up all transactions containing dexa scans.

Although we can enter free text directly to the item « comment », it may be more useful to create an « associated list » that we can consistently use for specific purposes. We can do this by using the configuration tool.

Note:

We now also have the possibility to use

any

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transaction names

.

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Let us now open the configuration tool and have a look at how to use an associated list with the transaction comment.

First you need to create a new associated list. You can use any item for this list.

However we suggest you use an item that you do not use for any other purpose. There is no need to use the HEALTH

one

TM

item « comments » for the purpose, but you may of course do so, if you wish. You should remember though, that the item you use will have this list in the normal HEALTH

one

TM

item associated lists.

In the example below I am have attached an associated list to the item

«comment measure».

Click on the menu item action

– assign list to transaction comment

Open a patient record in HEALTH

one

TM

and create a new transaction.

Click on the drop down arrow next to the « comment » attribute.

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Health One

Version 6.0 User Manual. Copyright

2010 Helix Health Ltd

HEALTH

one

TM

5.1

Miscellaneous features Page 11 of 11

Own Notes

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