Documentation/User_Guide/08.html

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   6 <title>OpenEMR v3.0.1 Users Guide</title>
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  13 <h1>OpenEMR Users Guide (version 3.1.0)</h1>
  14 <h3>Table of Contents</h3>
  15 <ul>
  16 <li><a href="01.html">Getting Started</a></li>
  17 <ul><!-- InstanceBeginEditable name="TOC1" --><!-- InstanceEndEditable --></ul>
  18 <li><a href="02.html">Main Screen & Navigation</a></li>
  19 <ul><!-- InstanceBeginEditable name="TOC2" --><!-- InstanceEndEditable --></ul>
  20 <li><a href="03.html">Setting Up Your Clinic</a></li>
  21 <ul><!-- InstanceBeginEditable name="TOC3" --><!-- InstanceEndEditable --></ul>
  22 <li><a href="04.html">Adding a New Patient</a></li>
  23 <ul><!-- InstanceBeginEditable name="TOC4" --><!-- InstanceEndEditable --></ul>
  24 <li><a href="05.html">Using the Calendar</a></li>
  25 <ul><!-- InstanceBeginEditable name="TOC5" --><!-- InstanceEndEditable --></ul>
  26 <li><a href="06.html">New Encounters & Coding</a></li>
  27 <ul><!-- InstanceBeginEditable name="TOC6" --><!-- InstanceEndEditable --></ul>
  28 <li><a href="07.html">Issues & Immunizations</a></li>
  29 <ul><!-- InstanceBeginEditable name="TOC7" --><!-- InstanceEndEditable --></ul>
  30 <li><a href="08.html">Patient Notes & Transactions</a></li>
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  32 <li>Patient Notes</li>
  33 <li>Transactions</li>
  34 <ul>
  35 <li>Referrals</li>
  36 <li>Basic Transactions</li>
  37 </ul>
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  39 <li><a href="09.html">Basic Billing</a></li>
  40 <ul><!-- InstanceBeginEditable name="TOC9" --><!-- InstanceEndEditable --></ul>
  41 <li><a href="10.html">Accounting & Receivables</a></li>
  42 <ul><!-- InstanceBeginEditable name="TOC10" --><!-- InstanceEndEditable --></ul>
  43 <li><a href="11.html">Reporting</a></li>
  44 <ul><!-- InstanceBeginEditable name="TOC11" --><!-- InstanceEndEditable --></ul>
  45 <li><a href="index.html">Index</a></li>
  46 </ul>
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  54 <h2>Patient Notes & Transactions</h2>
  55 <p>Patient notes store patient information that is unrelated to the patient's medical condition. Such information may include outstanding balances, changing insurance information or patient requests for actions by the clinic.</p>
  56 <p>Transactions are somewhat similar, but record events that have already occurred. These may be referrals, requests from either the patient or the doctor, or legal transactions.</p>
  57 <h3>Patient Notes</h3>
  58 <img src="Patient Notes & Transactions/02-notes-calendar.png" />
  59 <p>To begin, log in to OpenEMR, and use the search function in the lower left-hand corner to locate the patient for which you would like to add a note. </p>
  60 <img src="Patient Notes & Transactions/03-notes-patient_search.png" />
  61 <p>Click on the desired patient to bring up the 'Summary' page.</p>
  62 <img src="Patient Notes & Transactions/04-notes-patient_summary.png" />
  63 <p>If the user is not Authorized they will be unable to see the patient's medical details such as issues, immunizations and prescriptions.</p>
  64 <p>Click 'Notes (more)' to add a note for this patient.</p>
  65 <img src="Patient Notes & Transactions/05-notes-add_new.png" />
  66 <p>The 'Patient Notes' page will present you with a text box for entering the note, as well as drop-down lists for selecting the type of note, and the person to whom the note is addressed.</p>
  67 <p>Type your note in the text box and click 'Add New Note'.</p>
  68 <img src="Patient Notes & Transactions/06-notes-add_new2.png" />
  69 <p>The new note now appears in the list of notes on the same screen. The checkbox is used to control whether the note is "active". Above are options to view only the active or inactive notes. </p>
  70 <p>Click 'Patient Notes (back)' to return to the patient summary.</p>
  71 <img src="Patient Notes & Transactions/07-notes-add_new3.png" />
  72 <p>The new note is now listed on the Summary page.</p>
  73 <h3>Transactions</h3>
  74 <p>Click 'Transact' in the navigation menu to go to the Transactions page. (located under 'Patient/Client – Visits' in Tree View)</p>
  75 <p>The Transactions page contains two basic form types.  A simple form for internal transactions such as patient requests or billing transactions, and a Referral form.</p>
  76 <h3>Referrals</h3>
  77 <img src="Patient Notes & Transactions/08-notes-transactions.png" />
  78 <p>Select 'Referral' from the drop-down list to begin a new Referral transaction.</p>
  79 <img src="Patient Notes & Transactions/09-notes-transactions2.png" />
  80 <p>Another drop-down contains a list of physicians and clinics from the Address Book to which you can refer your patient.  Select the referring physician, risk level, etc., and enter a reason for the referral.</p>
  81 <p>Click 'Save Transaction'.</p>
  82 <img src="Patient Notes & Transactions/10-notes-transactions3.png" />
  83 <p>The referral is now in the Patient Transactions list. </p>
  84 <p>Click 'Referral' next to the transaction to generate a printable version of the Referral form.</p>
  85 <img src="Patient Notes & Transactions/11-notes-transactions-referral_form.png" />
  86 <p>Depending on your system's configuration, you may be asked to save the file, or it may be printed automatically.</p>
  87 <p>When you are finished return to the Transaction list and click 'Add Transaction'.</p>
  88 <h3>Basic Transactions</h3>
  89 <img src="Patient Notes & Transactions/12-notes-transactions4.png" />
  90 <p>Other transaction types use the simple transaction form. Select the desired type from the list and enter the  transaction details in the text box provided.  Click 'Save Transaction' when finished.</p>
  91 <img src="Patient Notes & Transactions/13-notes-transactions5.png" />
  92 <p>The new transaction has now been added to the list along with the referral.  Click on the date of a transaction to edit its contents.</p>
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