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If you prefer learning from a series of videos, you can refer to our EMR and EDR series here.
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Adding EMR/EDR to the Toolbar
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Once the EMR/EDR Ability has been added to your MacPractice license, you'll simply need to navigate to MacPractice Preferences located in the MacPractice Menu. Click "Abilities" in the Sidebar of the Preferences window, and in that section, click the Fetch License button.
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To add the EMR/EDR icon to the MacPractice Toolbar, right-click or Control-click the MacPractice Toolbar and select “Customize Toolbar”. From there, you can drag the EMR or EDR icon to a location on the Toolbar.
EMR/EDR Preferences
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You can access EMR and EDR Preferences from the MacPractice Menu > Preferences > EDR or EMR:
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This will allow you to decide when creating a new patient form what information you would like to pull for each section, giving you more granular control over how you handle each generated patient form.
Common Terms Used in EMR/EDR
The following are terms and their definitions that are commonly used in the EMR ability:
EMR: Electronic Medical Records
EDR: Electronic Dental Records (as it will be designated for Dental Offices)
Template: A template is an accumulation of sections where the content of a form will reside, but no patient data is visible. The fields of a template cannot be interacted with and patient data cannot be entered directly into a template.
Patient Form: Patient forms are created from templates. Once a template is selected and the green plus sign is clicked, this becomes a patient form. Data entered into a patient forms is specific to that patient and form and does not affect the template, except in certain cases.
Section: Sections are what make up the content of a template. Once a template is created, sections must be created and added to the template in order to add usable content to that template.
Element: Elements make up the different fields and options that have been added to a section. Text Fields, Labels, and Popups are a few examples of an element.
Form Side: This is the interactive side of a patient form where data pertaining to the patient is input.
Narrative Side: This is the "printable" view of a patient form. Data in this view cannot be edited. If a form is locked, only the narrative will be accessible for that form and no further changes can be made.
Pull Fields: The term "pull fields" can represent two different things - 1. "Narrative Pull Fields", which control what and how elements in a form section will show on the narrative of a patient form, and 2. "System Pull Fields", which pull data from other areas of MacPractice into the form and narrative. We can call these System Pull Fields, since they pull data from other parts of the system. System pull fields can be used on the form side and narrative side of a template, but Narrative Pull Fields are only used on the narrative side.
Data Pulling: This term can refer to data that pulls into a form, using the pull fields outlined above, or it can refer to the ability for data input into a patient form to be pulled into subsequent forms. Data pulling only works if you are creating another form with the same template, or if multiple templates share the some or all of the same sections in common.
Layout of the EMR/EDR Ability
The EMR/EDR Ability will appear slightly different depending on what node you have selected.
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You'll primarily work in the EMR/EDR Main View in the center of the EMR Ability. This will display the item you have selected in the Sidebar and will appear slightly differently depending on what you have selected. The Navigation Pane, for example, will only be available when a Template or a Patient Form is selected.
Sidebar
Standard Sidebar Features (seen across all MacPractice abilities):
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The above listed are all default folders, or nodes, in the EMR sidebar. These particular nodes cannot be removed or altered, though custom Category (pink) folders/nodes can be added in order to categorize templates. Custom Category folders that are created, but empty, can be deleted from the EMR Form Category Reference by selecting the category and clicking the red minus button. If you need to delete one that has template in it, drag and drop these templates to another category, then you will be able to delete once it is empty.
The Difference Between a Template and a Patient Form
Template: A “form” that contains no patient data and is not tied to a patient
Patient Form: Created from a template, but contains specific patient data and is tied to that patient in their account.
Menu Bar
The EMR/EDR Menu title contains the following items:
Import EMR/EDR Forms: When selected, a file selection window will appear, allowing you to select an .ETPL file that was exported using the Export Forms option described below. Any form templates present will be imported. You'll see a confirmation prompt indicating that the import is complete if successful.
Export EMR/EDR Forms: When selected, this option will open a window that will let you choose form templates to export. You can choose to export all, some, or a single form by checking and unchecking them. Once you have selected the forms you intend to export, click the Export button. You'll then be prompted to save the exported forms into a single file as a .ETPL file.
Send Form to Kiosk Machine: Allows users to send a selected Patient Form to the Kiosk for the patient to fill out.
Show Layout Rectangles: Shows a red border around each element (as pictured) when in a Form Section.
Toggle Narrative/Form: Toggles the form between Narrative and Form views. The Form view is the side where data is input for the patient; The Narrative view is the printable view of the form. For the most part, only data which is input on the form side will show on the narrative (this will depend on if the form has been constructed properly). Sections and element within the sections that aren’t interacted with will not show on the narrative. Essentially, the narrative is the “final report” for that particular patient visit.
Toggle Palette: This option brings up the Forms Palette, which is used to edit and examine Form Sections, Form Templates, or Patient Forms. Click the link to learn more.
Print Patient Forms: This option will either be listed as "Print (Patient Name)'s Patient Forms", or "Print Multiple Patient Forms", depending on if you have a patient selected or not. If a patient is selected, this window will only display forms for that patient. This will open a window where you can search for and select which forms you'd like to print.
Print Narrative: Prints the Narrative View of selected form.
Upload Form to Shared Forms: sends a copy of a selected template to MacPractice to share with other offices. Templates do not contain patient data, so this will not upload any patient data to shared forms.
Form Table View and the Clinical Ledger
The lower table at the bottom of the EMR / EDR Ability will display different depending on whether a Form Section is selected, or a Patient form is selected.
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When a Patient Form is selected, this view can either be the Form Table View or the Clinical Ledger. You can toggle between the two by Control-Clicking or Right-clicking on the table. If you want to adjust the default, you can adjust the Default View by navigating to EMR/EDR Preferences in the MacPractice Menu > Preferences > EMR or EDR, and checking the Others Tab as shown below, specifically the "Default View Below Form" selector.
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Form Table View
By default, the Form Table View is visible, which will display a record of this patient's responses when filling out this particular patient form. You can note the responses in the subsequent columns.
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Clinical Ledger
The EMR/EDR ability's Clinical Ledger is a view of ledger entries and selected information from the View Options area.
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In Preferences, you can adjust the behavior when you double click an item in the Clinical Ledger's detail pane. If you check MacPractice Menu > Preferences > EMR or EDR > Others Tab, you can adjust the "When double clicking on an item in the Clinical ledger" selector. This will either allow you to be taken directly to that item in the same MacPractice window, or you can open a new MacPractice window.
Navigation Pane
The Navigation Pane will show differently depending on if you are selected on a template or a Patient Form.
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When selected on a patient form, as in Fig B., we see that only certain sections are listed, which happen to be sections that have a default section header (notice the dark gray “S”, “O”, “A”, and “P” section headers on this SOAP note example). When selected on a patient form, you can quickly jump to specific sections on a form by clicking that section in the Navigation Pane.
Fig A.
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Fig B.
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Narrative View
The EMR/EDR Narrative of a form displays a text layout of the form suitable for printing for a patient or another provider. The Narrative View of a form can be customized to an office's needs.
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You can read more about Narratives in our Building Templates article. There is a section of the article that goes more into depth about Narratives specifically.
Generating a Patient Form from a Template
Templates that have been downloaded from Shared Forms, imported, or created within the EMR/EDR ability can be used to generate Patient Forms.
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Go to the EMR/EDR ability (if you’re not there already)
Select the patient you are creating the form for (if you haven’t already)
Select a template from one of the pink category folders (nodes)
Click the Green Plus button (if you aren’t already selected on a patient when you click the Green Plus button, you will be prompted to select the patient at this point). You will then see a record added under the Patient Forms Node with any of the resulting pulled data. You can then navigate through the form using the Navigation Pane and the Main View to complete the Form. With some Form Elements like the Drawing View, you may need to utilize the Forms Palette to complete the section.
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Locking and Unlocking Patient Forms
Once a patient form has been filled out to completion, it is common practice to lock patient forms to ensure no changes can be made to them. There are several ways to lock a form, and once locked, they will be present in the Locked Patient Forms node.
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Click and Drag the patient form in the sidebar to Patient Forms to Locked Patient Forms. No Prompt will occur.
Use the Palette and select the Lock Form button. You will receive a prompt when locking the patient form.
Use the Menu Bar > Text > Move EMR/EDR Form to Locked. You will receive a prompt when locking the patient form.
Use commands on your keyboard with Control + Command + L. You will receive a prompt when locking the patient form.
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Unlocking
In the future, if an edit needs to be made to a locked form, you can click the Unlock button on the top right of the form. A duplicate will be made and the original will be archived. On the duplicated unlocked form, the Updated Date will change to the date it was unlocked, but the Procedure Date will remain the same.
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Printing Forms
You can print a selected Patient Form by pressing Command-P, or by navigating to the File Menu and selecting Print. If you are on the Narrative side of a Patient Form, the Narrative will print, which is typically recommended as the graphical elements of forms are not designed to be printed. You can toggle between the Narrative and the Form View by pressing Command-Backslash (\) or by selecting Toggle Narrative in the EMR/EDR Menu. If a background is used on the form, then the Form side will need to be printed, since the background will not show on the narrative. Using a form background is not recommended, except in specific circumstances.
Printing Multiple Forms
In the EMR/EDR Menu, there is an option that allows you to Print Multiple Forms for a patient.
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Start Date: The date set here will keep forms from before this date from showing
End Date: The date set here will keep forms from after this date from showing
If you want to print every form for the patient, you can leave the Start and End Dates blank, and then Select All.Filter By Form: Allows the user to print all patient forms or to select only specific forms (i.e. only print H&P forms for this patient)
Select All checkbox: Allows the user to check or uncheck all forms listed
Oldest to Newest dropdown: Allows the print order to print the forms from oldest to newest, or in reverse order, from newest to oldest.
Cancel: Cancels the print task
Print Forms: Allows the user to print the Form View of the selected forms
Print Narratives: Allows the user to print the Narrative View of the selected forms
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Archiving or Deleting Form Sections, Templates, and Patient Forms
Before going over the archive/delete process it is important to note the difference between Archiving and Deleting, which is:
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Deleting: Removes the template/form from the database entirely. In most cases, deleted records cannot be retrieved, except through a past database backup.
Deleting a Form Section
You can delete an unused Form Section by selecting the section under the Forms Sections node and clicking the Red Minus button in the sidebar. You can only delete Form Sections that are not being used in templates or patient forms. There is no option to archive a form section. If a form section is being used on a template/form, the Red Minus button will be greyed out and the section cannot be deleted.
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If a section on a template has been used on a patient form, then the section has patient data tied to it and it cannot be removed. If you attempt to remove the section you will receive the alert pictured below. See the Editing a Used Template section below for the proper process on how to make changes to a template that has already been used on patient forms.
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Archiving a Template
To Archive a Template:
Go to the EMR ability (if you aren’t there already)
Find and select the template from one of the pink category folders (you may have to click the arrow to the left of the category folder in order to see the contained templates)
Click the Red Minus button at the top of the sidebar and select Archive
Deleting a Template
To Delete a Template:
Go to the EMR ability (if you aren’t there already)
Find and select the template from one of the pink category folders (you may have to click the arrow to the left of the category folder in order to see the contained templates)
Click the Red Minus button at the top of the sidebar. If the template hasn’t been used on any patient forms, you will have two delete options:
Delete: Removes the template from the database, but retains the sections that were contained on that template.
Delete All: Removes the template and all of the sections contained on that template from the database, except any sections that are used on other templates. Using the Delate All option can help keep the Form Sections node less cluttered.
Archiving a Patient Form
To Archive a Patient Form:
Go to the EMR ability (if you aren’t there already)
Select the Patient (if you haven’t already)
Find and select the patient form from the Patient Forms or Locked Patient Forms node (you may have to click the arrow to the left of the node in order to see the records)
Click the Red Minus button at the top of the sidebar and select Archive
Deleting a Patient Form
*Note that you are removing patient data from your database that may not be recoverable when performing this action.
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Go to the EMR ability (if you aren’t there already)
Select the Patient (if you haven’t already)
Find and select the patient form from the Patient Forms node (you may have to click the arrow to the left of the node in order to see the records)
Click the Red Minus button at the top of the sidebar and select Delete. You cannot delete Locked Patient Forms.
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Editing a Used Template
Once a template is used for a patient form, there is now patient data associated to that template. This means that if any edits are made to that template, some considerations must be taken in how the form is edited in order to protect that patient data. The way we edit a form that has patient data associated with it, is by duplicating the areas we are editing.
The general rule is this - If you are deleting or renaming any of the existing content on a template, then you’ll need to duplicate. If you are simply adding new content, then you don’t have to duplicate, though you still can if you’d like. However, in an effort to maintain data pulling for the areas you’re editing, it is recommended to only duplicate when necessary or when data pulling isn’t needed for that section.
Data Pulling
What is Data Pulling? The term “data pulling” can be used in a few ways. This could mean:
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