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:

1. Pulling specific information from other parts of MacPractice into the form;
   When pulling data from other parts of MacPractice, this would utilize what are referred to as “System Pull Fields”. These are elements that can be added to the template that will pull in data from specific areas outside of EMR/EDR. For example, if you wanted to pull in the patient’s insurance information without having to type it manually on each form, you would add the insurance pull fields to the template. Since insurance information is likely already entered into the Patient ability, we can pull it in instead of re-entering that information again. These pull fields are added during the template construction process or added to a template later, as an edit. System Pull Fields can be added to both the Form and Narrative sides of EMR/EDR templates.

2. Pulling data from the Form side to the Narrative side;
   Each element (or field) you add to a form section will have a pull field associated to it. These are referred to as “Narrative Pull Fields”. When formatting the narrative side of a section during the template construction process, these Narrative Pull Fields are used to control what and how the data from the form side will show on the printable narrative view. If there is a certain element from the form side that we don’t want to show on the narrative at all, we would remove the pull field for this element from the narrative. Generally, we format the Narrative Pull Fields as closely as possible to how the corresponding elements are formatted on the form side. This formatting would include bolding and element position, among other things.
   In the following example, you’ll see that the elements used on the form side correspond with the pull fields on the narrative side. You’ll also see how the positioning of the elements can differ from the form side to the narrative side and a comparison between the template and patient form.

   Open

   

3. Pulling data from past forms into new forms
   Pulling data from form-to-form pertains to the ability to pull data from a previous form into a new form in order to be able to review what was covered on a previous patient visit and to keep the user from having to re-enter data that still pertains to the subsequent visit. Data that is pulled from a previous visit can then be overwritten, or added to, without affecting any data on the previous form.

   Form-to-Form data pulling is determined by the sections contained on your templates. Data pulling works at the section level, which means, if a specific section is used on multiple templates, data entered into that section in one form will pull into a completely different form, as long as the templates share that same section.

   For example, let’s say you have an H&P template that you collect patient data on once a year. If you create a form with the H&P template in January of 2018, then create another patient form with the same H&P template in January of 2019, since it is the same template, containing all of the same sections, all of the data from the visit in 2018 can pull to the visit for 2019. It is the same template and therefore uses the same sections.

   However, let’s say you have an Initial Exam form that you collect data on for a patient’s first visit, then a Follow-Up Exam form that you use for all subsequent visits. As long as both templates utilize the same sections, data can be pulled between the two. In this case, the Follow-Up form may be a more simplified version of the Initial Form, so you may only utilize some of the sections contained on the Initial from. In this case, the Follow-Up form won’t pull in all of the data the Initial Form has, but only those sections that are shared across both templates. If however, the Follow-Up form collects completely different data, and therefore utilizes completely different sections from the Initial form, then data pulling cannot occur between these two templates, even if some of the fields are collecting the same data.

   It is also important to note here that if you have two separate but identical sections and use one section on one template and the other section on another template, data will not pull for that section between those two templates. The two templates must use the same section in order to pull data between them. Even though the two sections may be identical in content, they are still two separate sections.

The Template Editing Process

The main rule to follow when editing sections on a template is:

If you are editing a template where none of the sections on the template have been used to collect patient data, then it can be edited in any way without duplicating. However, even if you haven’t used a section, if you’re making changes to a section that you aren’t sure you’ll want to keep, then duplicating is a good way to keep several iterations of a section, just in case you make changes that you decide you don’t want. Any section you end up not using, can be deleted later.

Once a template has been used to collect patient data, the process of editing that template are as follows -

Editing an Existing Section

1. Locate the template in one of the pink category nodes in the sidebar to the left

2. Once selected on the template, it is best to add a special character, such as an asterisk [ * ] or exclamation point [ ! ], to the beginning of the form title. You can do this from the Name field located in the palette. Then save your changes.
   *If you do not see the palette, Select the EMR Menu in the Apple toolbar and select “Toggle Palette”. You may have to do this twice in order for the palette window to appear.

3. Select the Edit Menu from the Apple toolbar at the top of the screen, then select Duplicate Record.

4. You will now have an exact duplicate of your template. Locate the palette again and remove the special character you placed at the beginning of the template title. This gives you a way to differentiate between the original and the newly duplicated templates, with the original being the only one with the special character in the title at this point.

5. Select the new template from the sidebar (if you’re not already selected on it) and locate the section you would like to edit.

6. Double-click on the section and this will take you to the section editor for this section.
   *You will notice that you are now selected on that section from the Form Sections node in the sidebar. You can access the section by going directly to it in the Form Sections node, but we recommend using the double-click method from the template in order to make sure you are editing the correct section, in the event that you have multiple sections with the same title.

7. Locate the palette and now place a special character int he section title, then save.

8. Select the Edit Menu from the Apple toolbar at the top of the screen, then select Duplicate Record.

9. Remove the special character from the duplicated section title, then save. You should now be selected on the newly duplicated section.

10. This is a new section and has no patient data tied to it, so you can now edit the section freely. Once you have your edits complete, save your changes.

11. You’ll then want to make the same edits to the narrative side of that section. Locate the EMR menu in the Apple Toolbar and select Toggle Narrative/Form (or use the shortcut by holding the Command key and tapping the backslash key [ \ ]). This will take you to the narrative of the form section where you will want to add the pull fields for the elements you may have added. If you were simply renaming existing elements, the pull fields for these will likely be there already. If you do not see the pull fields related to your changes, then they can be added one of two ways:
    1. Highlight and copy everything in the section. Click the Reset Default Narrative Sheet button in the palette and paste in what you copied without over writing anything. Add some spacing in between your original pull fields and the ones that were added after clicking the Reset button. You will see duplicates of most of your pull fields, but should also see the pull fields for the added fields. Copy/paste the new pull fields in the proper locations among the original pull fields above, then delete all of the duplicate pull fields. Save your changes.
    2. Locate the pull fields for the added fields in the “Pull Fields” portion at the bottom of the palette. Drag and drop the new pull fields into the correct locations amongst the existing pull fields. Save your changes.

12. Now that you have successfully edited your section, you will now need to add the new (duplicated) section to the new (duplicated) template. Locate and select the template from the pink category node in the sidebar. While selected on the template, scroll up and locate the section that you created. Do not click on the section or you will select the section instead of the template. In one motion, drag and drop the section to the template.

13. Once the section has been added, use the Navigation pane on the far right to drag and drop your new section to the correct order, as compared to the other sections. You should see the original section (with the special character in the title) still on the template. After your new section is in the correct position, select the old section on the template in the middle portion of the screen. Once you see the orange markers on the section, hit delete on the keyboard to delete the old section, then save.

14. You can now archive the original template by selecting the original template (the one with the special character in the title), click the Red Minus button, the click Archive at the prompt.

The following video outlines how to edit a section that has already been used to capture patient data (the steps outlined above). In this scenario, we want to change the Relationship field of the Emergency Contact section to an Address field. We don’t simply want to overwrite the existing field because it will affect past forms and data, so we will duplicate before editing. The process is as follows:

1. Duplicate the template and section being edited.

2. Make the edits to the section.

3. Add the edited section to the duplicated template (drag and drop the section position in the Navigation Pane, if needed).

4. Archive the old template (you can also archive the old section, if you’d like).

*You can download this video for better viewing from the “cloud” icon in the lower-right corner.

Open

Adding a New Section

1. After your new section is created Locate the template in one of the pink category nodes in the sidebar to the left

2. While selected on the template, scroll up and locate the section that you would like to add. Do not click on the section or you will select the section instead of the template. In one motion, drag and drop the section to the template.

3. Use the Navigation pane on the far right to drag and drop your new section to the correct order, as compared to the other sections, then save.