Confirm Delete

When you press the Delete button on the Patients|Information screen, a confirmation window will appear.

If the pet cannot be deleted because it is in use (normally because it has an owner), the text will be "xxxx has relationships and cannot be deleted. Do you want to deactivate it instead?"(where xxx is the name of the pet you are trying to delete). Pressing OK will unset its Active flag, Cancel will abort.

If it is in use but can be deleted (because it has no owner), the text will be "xxxx has relationships. Are you sure want to delete? This operation cannot be undone." (where xxx is the name of the pet you are trying to delete). Pressing OK will delete the pet as well as all references to it, Cancel will abort.

If the pet is not in use and can be deleted, the window will simply ask you to confirm the delete. Press OK to confirm or Cancel to abort. (This will only occur if the pet has no breed, taxes, discounts, etc set.)

Confirm Merge

When you press the Merge button on the Patients|Information screen, this confirmation window will appear.

Press OK to merge the patients or Cancel to abort.

Create/Edit

This screen is used to create or edit the patient record.

The fields in the header are as follows:
Id - the patient's ID
Name - the patient's name
Species - the species - choose from the ones available - this are set via Administration|Lookups|Species. This is a mandatory field.
Breed - the breed - choose from those available - these are set via Administration|Lookups|Breed. You can set this to None. Note that it is possible that a new patient is a breed that is not on the list. If you are not an administrator (and thus cannot add the new breed), you should set the breed to the special value 'New Breed' - as shown below, this will cause the New Breed field to be displayed so that you can enter the appropriate data. Note that in the example below, this system has a species 'Other' defined to allow for the case where the species is also new.

It is also suggested that after you have set the New Breed, and entered the patient's other details, that you call up Workflow|Messaging and send a message to the administrator saying 'need new species/breed Snake - Ball Python'. Note that the customer and new patient name will be automatically included in the message.
After the Administrator has set up the new breed, you can then go back and edit the patient to change the Breed from 'New Breed' to the correct one.
Colour - enter the colour
Sex - choose one of None, Female, Male, or Unspecified
Desexed - check the box if the patient has been desexed
Date of Birth - the patient's DOB
Age - this will display the patient's age in Patient Age Format set for the practice - see Administration|Organisation|Practice
Deceased - check the box if the patient is deceased - this will set the Deceased Date to today, and untick the Active box
Deceased Date - date of death - this cannot be in the future, and if set, the Deceased check box must also be checked and the Active box unticked.  If you enter a date and there was previously none, then the Deceased box will be ticked and the Active box unticked.
Active - untick this to deactivate the patient

See also Local Procedures.

The tabs are Customers, Identities, Referrals, Discounts, and perhaps Custom Fields - these are documented below.

Note that in some cases, the tabs have a Hide Inactive xxxxx checkbox. This is present when the item being attached to the patient (ie the patient-owner, the patient-location, the referral or the discount) can be deactivated (either by unsetting its Active flag, or if its To Date is in the past). In this case the item will remain attached to the patient, but the item will not be displayed and the patient will act as though the item was not attached. You can have these inactive items displayed by unchecking the Hide Inactive xxxxx box.

The Customers tab
This tab is used to add/delete/edit a) 'Patient Owner' records and b) 'Patient Location' records.

Patient Owner - A patient can have multiple owners either at the same time (because the ownership is shared) or sequentially (because the patient passes from one owner to another).

The screen is as follows:

The fields are:
Customer - the name of the customer
From Date - the date from which the ownership started
To Date - the date on which it ended

Note: Although shared ownership of a patient is allowed, you need to set this up by editing the customer's patient-owner entries to add another customer. If you edit the patient's customer-owner entries you will change the ownership of the patient, ie terminate the old ownership and start a new one.

Patient Location - the screen snippet is below, but see the discussion in the customer edit page.

The Identities tab
The Identities tab is used to set the patient's identities. Patients have three types of identities, Microchip, Pet Tag, and Alias. These are discussed in this order below.

The Microchip fields are:
Microchip - the microchip number/code
Description - an optional description of what the code represents
Implant Site - the site where the microchip is implanted. [The pull-down provides the four standard implant sites. If necessary these can be expanded by modifying the entityIdentity.microchip archetype.]
Implant Date or Scan Date - the date when the microchip was implanted, or when it was last scanned

The Pet Tag fields are:
Pet Tag - the Pet Tag number/code
Description - an optional description of what the code represents

The Alias fields are:
Alias - the alias - this can be anything appropriate
Description - an optional description of what the alias represents (in the above case 23990 was the client number in the RxWorks system that this data was converted from)

You might also was to use the Alias Identify for a real alias such as the 'kennel name'  BREEAMBERARGENTINA - no wonder they call him Bree for short ;-)

The Referrals tab
The Referrals tab is use to record both 'Referred To' and 'Referred From' referrals. As can be seen from the two snippets below, the fields for each are identical.

The fields are as follows:
Veterinarian - the vet - this is one of the Supplier/Vets - see Concepts|Suppliers for background. Note that if this is a new vet, then you can use the New button on the Veterinarian screen (displayed when you press the binoculars) to quickly make a new Supplier/Vet record. You can also enter the vet's practice name to get a listing of all vets in the practice.
Start Date - the start date of the referral
End Date - the end date of the referral
Reason - the reason for the referral

The Discounts tab
This tab is used to set the discounts that apply to the customer - see Concepts|Discounts for background.

The fields are:
Discount - the discount - note that this can either be a discount, or a discount group
From Date - the date from which the discount applies
To Date - the date on which the discount ends

The Custom Fields tab(s)
See Administation|Lookups|Species for a discussion of the custom fields facility.

The fields here will depend on the specific customer fields archetype.

Create/Edit Insurance Policy

This is the screen used to create or edit an insurance policy for a patient.

The fields are as follows:

Insurance Claim

This is the screen used to create, edit or view an insurance claim for a patient.

The fields are as follows:

Conditions

The Conditions tab lists the conditions being claimed.

The fields are as follows:

Conditions can be added using:

Attachments

The Attachments tab lists the attachments that will be submitted as part of the claim. These are a copy of the original documents, taken when the claim is submitted.
To see what documents will be attached, click the Generate Attachments button.

The following attachments will be automatically added:

• Patient History - the full patient history up to the time of the claim
• Customer Invoice - an invoice will be added for each invoice referenced by the claim

History

The History tab displays the patient history, and is provided to help construct the claim.
It does not represent the history that will be attached to the claim when it is submitted.

Gap Claims

A gap claim is one where an insurance claim is submitted to the insurer, and the insurer calculates a benefit amount. The customer pays the gap, which is the difference between the total claim and the benefit amount.
When making a gap claim, all of the invoices in the claim must be unpaid.

Gap claims are only available for online insurers.

When Gap Claim is selected and the claim is submitted, the Gap Claim Status will be Pending, indicating that the insurer hasn't yet set the benefit amount.
When the insurer sets the benefit the:

• Benefit Amount is updated; and
• Gap Claim Status is updated to Received; and
• any notes from the insurer are recorded in the Benefit Notes

The customer can elect to:

• pay the gap, i.e. the difference between the claim Total and and the Benefit Amount.
  The insurer will reimburse the practice to the value of the Benefit Amount.
• pay the full claim.
  Here, the insurer will reimburse the customer.

When the claim is paid, the Gap Claim Status will be set to Paid, and finally to Notified, when the insurer is notified of the payment. This last step is required to allow the insurer to reimburse:

• the practice, if a gap payment was made
• the customer, if full payment was made

Confirm Delete

This is the delete confirm screen. Press OK to proceed, else Cancel.

Confirm New

Depending on which tab of the Medical Records or Visit Editor screen that you have open, this window allows you to select the type of medical record entry, alert/reminder, or document to be created. Select the required one and press OK, else Cancel to abort.

For the Summary tab, the window is: (the partially visible last item is 'Weight')

For the Reminders and Alerts tab, the window is:

For the Documents tab, the window is:

Confirm Refresh

This window is displayed when you press the Refresh button to refresh a letter from its template. Press OK to confirm, Cancel to abort.

If Version current document is checked, then when the letter is regenerated, the current copy will be saved as a version, otherwise it will be replaced.

Create/Edit Alert

This is the screen used to create or edit a patient Alert. See Concepts|Alerts for background.

The fields are as follows:
Date - the start date for the alert
End Date - the end date for the alert. This can be left blank if the alert has no end date.
Alert Type - select from those available - these are set via Administration|Types|Patient Alert Type
Reason - a short version of the Notes text
Product - the product that created the alert, if any
Author - the user that created the alert
Clinician - the associated clinician
Notes - the long version of the reason for the alert
Status - can be either In Progress or Completed
 

Create/Edit Attachment

This is the screen used to create or edit an attachment document in the patient's medical records. See Concepts|Documents for background. Note that although you can use this facility to attach an image file, it is probably better to use the Image facility for this.

The fields are as follows:
Start Time - the date on which the entry was created - defaults to today
Description - any pertinent description
Status - this can be In Progress, Completed, or Finalised.  In Progress implies that you are still working on this; Completed implies that you have finished - but the entry can still be editied; and Finalised means that it is really complete and can no longer be edited.
Printed - this box will be checked when the form has been printed
Clinician - the appropriate clinician
Attachment - press the Select button to attach the file - after the file is attached its name (notes.txt in this case) is shown here.

The Versions tab shows the previous versions. Note that you can use the Add button to add another, but you can also use the Select button.  If you use the Select button to attach another file, then the previous 'top' version will just be pushed onto the version list.

As you can guess from the above, there is no problem in adding the same file name twice. In fact although two notes.txt files have been attached, each in fact contains different text.

Create/Edit Form

This is the screen used to create or edit a form document in the patient's medical records. See Concepts|Documents for background.

The fields are as follows:
Start Time - the date on which the entry was created - defaults to today
Description - any pertinent description
Status - this can be In Progress, Completed, or Finalised.  In Progress implies that you are still working on this; Completed implies that you have finished - but the entry can still be editied; and Finalised means that it is really complete and can no longer be edited.
Printed - this box will be checked when the form has been printed
Form - select the form to print - these are the document templates that are of Type 'Patient Form'
Product - select a product if appropriate. This is here so that if the form selected is sensitive to the current product, the form can include product information.  Thus, for example, we do not have to have a vaccination certificate for each type of vaccination - we can just have a general certificate that prints the name of the current product.
Clinician - the appropriate clinician - normally the form will display the clinician's name

Create/Edit Image

This is the screen used to create or edit an image document in the patient's medical records. See Concepts|Documents for background.

The fields are as follows:
Start Time - the date on which the entry was created - defaults to today
Description - any pertinent description
Status - this can be In Progress, Completed, or Finalised.  In Progress implies that you are still working on this; Completed implies that you have finished - but the entry can still be editied; and Finalised means that it is really complete and can no longer be edited.
Printed - this box will be checked when the form has been printed
Clinician - the appropriate clinician
Image - press the Select button to attach the file - after the file is attached its name (Bree.jpg in this case) is shown here.

The Versions tab shows the previous versions. Note that you can use the Add button to add another, but you can also use the Select button.  If you use the Select button to attach another file, then the previous 'top' version will just be pushed onto the version list.

Note that there is no problem in adding the same file name twice. Thus if your images arrive in files called img001.jpg, there is no problem if there is already an image imported from a file named img001.jpg.

Create/Edit Investigation

This is the screen used to create/view/edit investigations.  For background see Concepts|Investigations.

The fields are as follows:
Start Time - the date on which the investigation was initiated
Investigation Type - the type of investigation - these are set up via the Administration|Types|Investigation screen
Notes - you can enter any appropriate notes
Status - this will initially be 'In Progress' - for other settings see Concepts|Investigations
Order Status - the status of the order. This will initially be 'Pending' to indicate that the order has not been sent. For other settings see Concepts|Investigations
Clinician - the associated clinician
Report - use the Select button to add the results report to the investigation. Note that if there is an existing report and you add another, the first will be pushed down into the Versions tab. You can upload any sort of file at all. If you are using the automatic facility (see Concepts|Investigations) to attach investigation results, then you should not have to use the Select button to attach results.

The Print Form button is used to reprint the Investigation form.

The Versions tab is used to display and manage the versions of the reports. Normally the Add button is not needed - as discussed above you just use the Report|Select button to add a new version of the report. The display area shows the previous versions in a column format. Selecting a version causes its fields to be displayed (and these are the same as above). The column headings are:
Date - the date of the version
Description - this showns the Notes field
Document - this shown the results file - you can click on it to download and display it.
 

Create/Edit Letter

This is the screen used to create or edit a letter document in the patient's medical records. See Concepts|Documents for background.

First lets look at the screen shot for a new letter:

The fields are as follows:
Start Time - the date on which the entry was created - defaults to today
Description - any pertinent description
Status - this can be In Progress, Completed, or Finalised.  In Progress implies that you are still working on this; Completed implies that you have finished - but the entry can still be editied; and Finalised means that it is really complete and can no longer be edited.
Printed - this box will be checked when the letter has been printed
Clinician - the appropriate clinician
Template - select the template to be used - these are the document templates that are of Type 'Patient Letter'
Document - you DO NOT need to press the Select button when you are creating a new letter. Simply selecting the Template will generate the letter from the template and insert the appropriate information.

Now the edit screen. The senario is as follows: you created the letter as above.  Then you decided that you needed to edit it, so on the Documents tab of the Medical Records screen, you selected the letter and then clicked on the actual letter to download it and open it in your word processor. You then saved a copy (as say Referral Letter-2), edited in the required changes and then saved it.

On the Medical Record screen you now press the Edit button to get the Edit Letter screen. You then press the Document Select button - this will open a browse window to allow you to select your 'Referral Letter-2' and upload it. The screen will then appear as below. The initial version has been saved as the previous version, and your new one as the new current version.

As intimated above, the Versions tab shows the previous versions. Note that you can use the Add button to add another, but you can also use the Select button.  If you use the Select button to attach another file, then the previous 'top' version will just be pushed onto the version list.

There is no problem in adding the same file name twice. In the above example the file names were different but they could have been the same.

Parameters

If a template containing parameters is selected (i.e. Fill-In fields in Microsoft Word, or Input Fields in OpenOffice Writer), a window like that below will be displayed prompting for the values of those parameters. On OK, these will be merged with the document. Note that the order of the prompts cannot be specified, ie if the template has prompte P1, P2 and P3, these may be displayed on the screen in the order P2, P1, P3.

The parameters are normally text fields and hence you can use macros to enter the information.

Create/Edit Medication

This is the screen used to create or edit a medication entry in the patient's medical records.

If the medication entry is being created as a result of invoicing the item, then this screen will only be displayed if the medication product entry has it's Dispensing Label option ticked. It is always displayed to edit the medication entry, or if the entry is being created via the New|Medication button on the Patients|Medical Records screen.

The fields are as follows:
Date - the date the medication record was created - defaults to today
Expiry Date - if a Batch has been selected, this represents the Batch expiry date. If not, you can enter the expiry date of the medication. Note that you can enter a relative date (e.g. 2m for 2 months from today).
Quantity - the quantity
Label - the label text- this will be initially set from the medication product record
Print Label - pressing this button prints the label using the template, 'Drug Label'
New Prescription - creates a new prescription from the medication, copying the Medication, Quantity and Label. The Clinican will default to the current clinician, if any.
Medication - the medication product
Batch - the product batch. If selected, this determines the Expiry Date. The Batch dropdown displays all active batches of the medication at the current stock location. The batch with the earliest expiry date is shown first.
Clinician - the clinician
Dispensing Notes - these will be displayed if there are any

Note that if it is important to you that the Dispensing Notes be displayed when the item is added to the invoice but you would not normally print a label (and hence the product's Dispensing Label option is not ticked), you should edit the product to have the Dispensing Label option ticked, but either leave it's Label Text blank, or set to say 'No label required'.

Create/Edit Note

This is the screen used to create or edit a note in the patient's medical records.
The patient history is displayed below, for reference.
 

The fields are as follows:
Date - the date of the note - defaults to today
Note - the note text goes here. If needed you can change the size of the note window using the handle at the bottom left of the text window.
Clinician - the clinician

Create/Edit Prescription

This is the screen used to create or edit a prescription. See Concepts|Prescriptions for background. In the picture below, the prescription has already been dispensed once so the 'Dispensing' tab is shown. If the prescription was being created the Dispensing tab would be absent.

The fields are as follows:
Date - the date on which the prescription was created - defaults to today
Expiry Date - the date on which the prescription expires. After this date, the prescription cannot be dispensed nor deleted. Note that this is totally separate from the Expiry Date set when you dispense the item - which is of course the expiry date of the dispensed medication. This date defaults to today plus the Prescription Expiry interval set for the practive - see Administration|Organisation|Practice. If you have not set this, then it defaults to zero and the Expiry Date will default to today.
Quantity - the quantity to be dispensed each time
Repeats - the number of repeats
Medication - the product
Label - the dispensing label text - this defaults to that set for the product. This will be the label when you actually dispense from this prescription.
Clinician - the clinician
Times Dispensed - the number of times that this prescription has been dispensed.

The Dispensing Tab shows the information for previous dispenses of this prescription.

Note that when you set up the prescription, you are functionally authorising the dispensing a total of (qty x (repeats+1)).  Hence if you set the Quantity to 2 and the Repeats to 5, the total quantity being authorised is 12.

Note also that when the prescription is dispensed neither the Quantity nor the Label text can be altered. If these do need to be altered, this must be done by editing the prescription itself.

Create/Edit Problem

This is the screen used to create or edit a problem in the patient's medical record. See Concepts|Problems for background. The following screen shows a problem being edited.

The fields are as follows:
Date - the date the problem was created - defaults to today
Presenting Complaint - the presenting complaint
Diagnosis - the problem diagnosis
Status - this can be Unresolved or Resolved
Resolved Date - the date on which the problem was resolved
Clinician - the associated clinician

Create/Edit Reminder

This screen is used to create and edit reminders. Normally reminders are created automatically by the system (ie as a result of invoicing an annual vaccination, the system will create the reminder for the next one), but they can also be created manually using this screen.
Similarly, they are normally processed automatically by the Reporting - Reminders processing. However, in some circumstances you may want to cancel them or change their due date manually.

The fields are as follows:

Reminder Type - the Type of the reminder
Due Date - the date when the reminder is due
Next Reminder - the date when the reminder is next due to be sent. This is calculated as the Due Date plus the Interval for the current reminder count.
Status - this can be In Progress (ie active), Completed (ie the associated event, eg the vaccination, has occurred), or Cancelled. Normally the system will adjust the state to Completed (when the event occurs) or Cancelled (when the reminder becomes too old), but you can also change the state using this screen.
Reminders Sent - displays the number of reminder notifications generated. Note that if the same reminder was sent by say both email and SMS, this only counts as 1, not 2 reminders sent, as we sent the same reminder by two methods. However, the items display will show both of these, and they will have the same reminder count.
Last Sent - the date on when the reminder was last sent
Completed - the date on which the reminder was completed. Note that if the reminder is cancelled by the system, the date on which this happened is not shown here, is this is a Completed date, not a Cancelled or Completed date.
Product - the associated product
Clinician - the associated clinician

Items

The items tab shows the times and methods by which a reminder has or will be sent.

Create/Edit Visit

This window is used to create or edit the patient's visit record. Note that if you are using the workflow facilities, and in particular the Consult button on the Workflow|Work List screen, then the visit record will be created for you.

The fields are as follows:
Start Date - the date on which the visit started - defaults to today
Complete Date - the date on which the visit was completed
Reason - the reason for the visit
Summary - an optional summary of the visit
Clinician - the clinician
Status - you can set this to In Progress or Completed

The Print button will print the complete visit information (ie including notes, medication, weight, etc) - not just the above information.

Add Problem to Visit

This prompt is displayed when creating a new Problem:

New Problems can be added to the most recent Visit, or to a new Visit.

Click:

• OK to add the Problem to the selected Visit
• Cancel to cancel Problem creation

Create/Edit Addendum

This is the screen used to create or edit an Addendum in the patient's medical records.

Addendum records are used to annotate Medication or Note records after they have been locked.

The patient history is displayed below, for reference.

The fields are as follows:

• Date - the date of the record was created
• Note - the note text
• Clinician - the clinician

Create/Edit Weight

This window is used to create or edit the patient's weight record.

The fields are as follows:
Date - the date on which the weight was measured - defaults to today
Weight - the weight
Units - the units - you can select Grams, Kilograms, or Pounds
Clinician - the clinician

New Medication Record prompt

The New Medication Record prompt is displayed when creating Medication records  from:

• Patients|Medical Records|Summary
• Patients|Medical Records|Problems

When Medication records are created this way:

• the customer is not invoiced
• the medication quantity selected does not change the stock level

If there is no need to invoice the customer, or change stock levels, click OK.

If the customer should be invoiced, then click Cancel, and add the medication via:

• Customer|Charges
• the Visit Editor

New Visit & Note

This screen is used to create both a patient Visit and a Note in the patient's medical records.

The patient history is displayed below, for reference.

This should NOT be used to create a normal consult visit (for this you should use the Check-In button on the Workflow - Scheduling screen). It is intended for use when creating a note unrelated to another visit, say as a result of a phone call.

The fields are as follows:
Date - the date of the visit and note - defaults to today
Reason - the reason for the visit
Note - the note text goes here. If needed you can change the size of the note window using the handle at the bottom left of the text window.
Clinician - the clinician to assign to the visit and note