This article covers the functionality inherent in the EMR & EDR Ability in MacPractice, which is used to design, utilize, and manage electronic patient forms. This article will focus on the specifics of the interface and what each area does.
noteIf you're interested in how to build templates, please check out our Building Templates article here.
noteIf you prefer learning from a series of videos, you can refer to our EMR and EDR series here.
Adding EMR/EDR to the Toolbar
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.
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
You can access EMR and EDR Preferences from the MacPractice Menu > Preferences > EDR or EMR:
This Preference category is split into three tabs. You can read more about EMR/EDR Preferences here.
The main recommendation we have is to ensure that in the Data Tab, you have the"Ask Me What To Do For Each Section" option selected under "When a new form is created”.
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.
Layout of the EMR/EDR Ability
The EMR/EDR Ability will appear slightly different depending on what node you have selected.
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):
Patient Selector: allows you to search and select a patient. When you are selected on a patient, you will only see forms for that patient in the Patient Forms node. If you are not selected on a patient, you will see patient forms that have been created for all patients.
Highlight Color Selector: allows the user to highlight certain selections in a particular color. If you select a section in the Forms Sections node, or a template in one of the tempalte category folders, you can select a color to highlight that particular record.
Plus/Minus Buttons: used in creating or deleting/archiving records. You can only delete unused sections (sections that aren’t currently on any templates. You can archive or delete templates or patient forms. If archived, they can be retrieved from the Retrieved Archived option under the File Menu. If deleted, the template or patient form is gone forever, and cannot be retrieved, except through a backup.
Search Bar: allows the user to search a particular selection in a given node. If the Form Section node is selected, this will search section titles in that node; If a templates folder is selected, this will search template titles in that node, and so on.
EMR/EDR-Specific Folders (Nodes):
Form Sections (purple): This folder contains all form sections, which
are blocks of assembled Form Elements, that have been created or imported into the database. Sections in this folder may or may not exist on templates, but are available to be added to templates. Use the green plus button to create a new section and the red minus button to delete a section. If a section is used on a template that has been used for a patient form, that section cannot be deleted and red minus button will be greyed out.
General (pink): This is a default Template Category folder where templates can be created using the Green Plus button. Templates will be comprised of sections located within the sections node above.
Downloads (pink): This default folder is where any templates imported into MacPractice or downloaded from the Shared Forms Library will reside. These templates can be drag and dropped into other category folders, such as General, or a custom category. If none have been downloaded, this Category won't be present.
Unarchived (pink): The folder contains any templates that have been
Patient Forms (blue): This folder stores any forms created for patients. If you are selected on a patient, this is where you will see all of their past patient forms. If you are not selected on a patient, this folder will show all past patient forms for all patients.
Locked Patient Forms (blue): This folder will contain patient forms that have been locked. Locked forms prevent any further edits or changes to that particular form. The only way to edit the content of a locked form is to click the Unlock button on the top right of the form. A duplicate will be made and the original will be archived.
Note Templates (yellow): This folder gives the user access to Notes templates that can be used to pull in EMR form narratives.
Shared Forms (cloud icon): The Shared Forms Library contains pre-made templates that can be downloaded and used by any office. In order to view a form, it must be imported into the system, which will go to the Downloads folder. Within the Shared Forms Library you will see:
Select Specialties Filter: Allows the user to select a specific medical specialty a forms may be designated for.
Form Version Filter: A form may go through several iterations of updates. This filter allows the user to select a version designation. The higher the number the most recent, but generally all versions would be searched. By default, versions 3 and 4 are selected, which will return the most results.
Apply button: Commits the selected filters and searches based on the filter criteria.
Main Window: Shows the resulting list of templates/template bundles. Categories in this window are:
Form Version: Shows the version a particular template or bundle is designated as.
Form Name: Shows the name of the template or bundle.
Specialty: Shows the medical specialty the template or bundle is designated as.
Description: Usually indicates the number of templates in a given bundle. This will be the number of templates added to your database, if downloaded.
Created: Date and time the template or bundle was added to the Shared Library.
Approved: Indicates templates or bundles approved for sharing.
Uploaded By: Indicates the user that added the template or bundle to the Shared Library.
Download button: Downloads the selected templates or bundle to the Downloads folder in EMR. Templates and bundles can only be downloaded one-at-a-time. Command and Shift-selecting is prohibited in this area.
EMR Form Category (reference): This node allows for custom Template Category Folders (the pink folders) to be created. This allows the user to create categories where they can organize the various templates they have, so they don't have to store everything in the General folder. To create a new Form Category node, select the EMR/EDR Form Category node then click the plus sign to create a new record. As you can see in the screen shot above, the titles in this node correspond to the pink category folders in the Sidebar. When adding a Form Category you will see the following fields:
Family History (reference): Not Used.
Sensitivities (reference): Not Used.
Social History (reference): Not Used.
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.
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.
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
Filter By Form: Allows the user to print all patient forms or to select only specific forms (i.e. only print H&P forms)
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
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.
With a Form Section selected:
When a Form Section is selected, this table will display all patients who have this form section included on a patient form connected to them, as well as columns summarizing the data entered.
With a Patient Form Selected:
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.
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.
Clinical Ledger
The EMR/EDR ability's Clinical Ledger is a view of ledger entries and selected information from the View Options area.
The Incident pane displays all active and archived incidents and the information that has been associated to the incident for the patient.
The View Options menu sets the information that will display in the Clinical Ledger pane. This information is separate from the Ledger > View Options and will not affect the Ledger's display.
The detail pane displays basic information about an item.
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.
As you can see from the Fig A. below, when selected on a template, the Navigation Pane will show a list of all sections present on this particular template. When constructing a template, you can use this pane to drag and drop the order of your sections. Sections that do not have a section header will show greyed out, but can still be reordered. Whether or not a section header shows is controlled via the “Show Title” check box in the palette. The title will show if this is checked.
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.
Fig B.
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.
To switch to and from the Narrative and Form Views, you can navigate to the EMR/EDR menu and select Toggle Narrative/Form. Alternately, you can press the Command and Backslash keys on your keyboard to flip the form between Narrative and Form view.
You can print the Narrative view of a form by navigating to the File Menu and selecting Print, or by pressing the Command and P keys on your keyboard.
noteYou 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.
To generate a form for a patient, select the template you wish to generate, then click the Green Plus button. If a patient is not selected, you'll be prompted to select one.
Forms that have been generated for a patient will appear in 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.
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.
You can identify if a form is locked by the notification bar at the top of a locked patient form.
You can lock a patient form by:
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.
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.
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.
Printing Multiple Forms
In the EMR/EDR Menu, there is an option that allows you to Print Multiple Forms for a patient.
If you have a patient selected, the EMR/EDR Menu will have an option that says Print (PATIENT'S NAME) Patient Forms. If no patient is selected, this option will instead state "Print Multiple Patient Forms".
From here, a new window will open that allows for a date filter. With the date filter you can set a beginning and end time to search for specific forms within the time frame. If a patient was selected, you will only be able to see results for that specific patient.
The Filter By Form dropdown allows you to see only the selected form that was used in your specific date range.
If you choose the Select All box, you will be able to select every form that is listed. If you want to print every form for the patient, you can leave the Start and End Dates blank, and then Select All.
You are also able to select if you want to print the form side or the narrative side with the buttons at the bottom of the window.
Deleting Forms, Form Sections, and Templates
Deleting or Archiving a Patient Form
You can delete or archive a Patient Form by selecting the Patient Form in the sidebar and clicking the Red Minus button. You'll be prompted whether you want to delete or archive the form.
Deleting a Form Section
You can delete an unused Form Section by selecting the Form Section and clicking the Red Minus button in the sidebar. You can only delete Form Sections that are not being used in any patient forms.
To remove a Form Section from a form, simply click it from within the Main View of the form. With the section selected, press the delete key on the keyboard and click the Remove button on the resulting window.
Deleting a Template
To delete a Template, select the Form Template in the sidebar and click the Red Minus button. If the form has been used for a patient, it cannot be deleted. However, you will be prompted whether you'd like to delete or archive a Template. An archived form will remain within the database but will not appear in the EMR/EDR sidebar. We strongly recommend archiving any Template that has used previously.
If the form has not been used for a patient, you'll instead be prompted whether you'd like to delete the accompanying Form Sections as well. Please note that Form Sections that are being used in other forms will not be deleted if you choose Delete All.
