CHART

CPS Training for New Providers (AMB100)

Centricity Practice Solution 12

Abstract
This training manual is intended to be used by providers or other clinical staff that have proper
security permission to access Charts. Users with proper permission can document patient care
during office visits, place orders, review results, and create notes or document other clinical
related tasks.

AHF EMR TRAINING

Updated: July 2, 2019
Document 100-201
CPS PROVIDER TRAINING

AMB100 CPS TRAINING FOR NEW PROVIDERS

 CHART

Contents
Overview ....................................................................................................................................................... 1
Login / Logout ............................................................................................................................................... 2
Main Menu.................................................................................................................................................... 4
Part 1. Begin your day from here: Chart Desktop ......................................................................................... 5
Chart Desktop: Manage Appointments .................................................................................................. 10
Chart Desktop: Manage Secure Messages (Alerts/Flags) ....................................................................... 12
Chart Desktop: Manage Documents ....................................................................................................... 15
Part 2. Writing Notes in CPS: Updating Charts ........................................................................................... 16
What is a New Document? ..................................................................................................................... 17
Document an Office Visit (face-to-face encounter) ................................................................................ 20
Document Clinical List Changes .............................................................................................................. 25
Part 3. Review Patient Charts ..................................................................................................................... 26
Part 4. Medications and Placing Orders...................................................................................................... 31
Part 5. Update Chart from the Ribbon: Phone Note / Refill Prescription ................................................... 36

i
 CHART

Overview
GE Centricity Practice Solution (CPS) was designed to support ambulatory clinics and is a fully
integrated electronic health records (EHR) and practice management system (PM).

CPS allows Ambulatory Healthcare clinics to:

 Deliver best care

 Place Electronic Orders (for labs or medications)
 Capture Raw Data for Reporting Metrics (population health reporting)
 Capture charges
 Streamline billing

1
 CHART

Login / Logout

There are two ways to login into CPS: Desktop Shortcut or Browser

Desktop Shortcut

Click on this shortcut

OR
Browser

Enter the following address in Internet Explorer (recommended) then follow steps A, B, and C below:

https://storefront.aidshealth.org

2
 CHART

Hint: Press Tab key to move to next field

3
 CHART

Main Menu
After you login, the Main Menu window opens. You access different CPS modules from the Main Menu.

To access the Chart module, click on the blue button in the vertical menu or from the main toolbar
located on the top of the screen.

4
 CHART

Part 1. Begin your day from here: Chart Desktop

This chapter introduces the Chart Desktop and explains the basic functions to review your
appointments, read or send secure internal messages, and take appropriate action on different types of
clinical documents that require you to review or sign. It includes the following topics:

 Summary Screen
 Ribbon and Left Menu
 Actions Available from Chart Desktop
 Appointment Pane
 Alerts and Flags Pane
 Documents Pane

5
 CHART

Summary Screen

The first screen that automatically opens after you select Chart from the Main Menu is called the Chart
Desktop Summary screen. Think of the Chart Desktop as your “home page” or “dashboard” and the
Summary screen as a your “to-do list”.

The Summary screen offers you a quick view of today's workload:

 Your patient appointments for today

 Secure Messages (Alerts/Flags) from other clinic staff
 Clinical documents that require your attention

The summary screen displays a consolidated view of the following three panes:

 Appointments
o Displays a view only look at your schedule.
 Alerts/Flags (messages)
o Displays a summary view of internal messages which can be opened and addressed from
this screen. Messages are not a permanent part of a patient record unless converted to
a document.
 Documents (aka queue)
o Displays a summary view of patient documents that require your attention. Documents,
after being signed, become a permanent part of a patient record.

6
 CHART

Ribbon

The horizontal menu in the chart desktop, is referred to as the Ribbon, is organized by functional areas and has
icons that allow you to perform actions such as finding a patient, viewing documents, start new messages
(Alerts and Flags) and printing.

The ribbon can be minimized which allows for more working space on the Desktop. Utilizing the ^ symbol in the
upper right corner collapses the menu.

To keep certain elements from the ribbon in a quick access area, right click and select “Add to Quick Access
Toolbar”. This allows for the ribbon to stay collapsed and yet the user still has the ability, in a single click, to
access the desired function.

The ribbon is organized as follows: (from left to right)

Search: Find Patient Buttons (2)

There are two buttons to find a patient. These buttons will remain static and appear in all areas of the chart.
You can also use keyboard shortcut CTRL + F to find a patient.

Documents
Manage documents that appear in the documents pane. View attachments, sign and see a contributors list.

Alerts/Flags
Create a new message (flag), patient alert or refresh the alerts/flags pane.

Desktop
This option is not used.

Print Icon
Print certain documents.

7
 CHART

Left Menu

The Left Menu contains links that will take you to different modules or areas within CPS. Buttons can be added
or removed based on your personal preference by selecting the button on the lower right of this pane.

8
 CHART

Actions Available from Chart Desktop

Alerts and Flags

A flag is a temporary non-care related message you send to another user on the CPS system.

A care alert is a message that contains patient care-related information about a specific patient that you
send to another user. Care alerts are always attached to a patient chart. When a message is attached to
a patient chart, the message becomes a permanent part of the patient record.

You can view and manage care alerts/flags from your Desktop or from a patient's chart. When you open
an item, the location where it is attached also opens. For example, when you open an alert associated
with a patient chart, the chart opens. Just click Convert to turn the message into a chart note.

Regardless of where care alerts/flags are attached, they are always listed on the recipient's Desktop.

Documents
In the patient chart you can review, manage, and act on patient documents, review attachments,
related documents and document contributors, and complete pending orders.

Remember: Use Filters to find document types and Column Headers to Sort Data within the list pane.

File Attachments (not used by providers – Document Management System – performed by FO staff)
Users granted access to Desktop > File Attachments can add a scanned report, an image, or other
external file directly to a patient chart without opening the chart. From the Desktop, you can create a
chart document with a link to the external file or add a file to an existing document. For example, you
can attach word processing documents, images, Adobe Acrobat PDF documents, and other files.

Messaging (Unsupported/Disabled/AHF DOES NOT USE THIS FUNCTION)

Scheduling (not relevant or part of provider role/provider has permission to view)

The Scheduling module allows clinic staff to set up patient appointments. It allows them to schedule,
change, and cancel appointments.

Registration (not relevant or part to provider role/provider has permission to view)

The Registration module application allows clinic staff to create and manage patient records. It allows
them to enter, modify or update address, name and other demographic elements for each patient. It
also allows them to add and manage guarantor, pharmacy, contacts, insurance and coverage
information.

9
 CHART

Chart Desktop: Manage Appointments

Appointments Pane
View your appointments for today and access patient information or select a different day from the
Date to view list.
By default, the calendar shows a read-only view of your patient appointments for the current day. You
can, however choose to view a different day.

Note: Your schedule will only appear in the Chart Desktop Summary

Different ways to open a chart from Appointment pane:

 Highlight appointment and click on the Open Chart Icon (chart will open)
 Double-click on the appointment (chart will open)
 Right-click on appointment to open chart or go to another module

10
 CHART

Appointment Details

When you hover over any appointment, a pop-up window will appear and provide more specific details
about that appointment. See image below.

Additional things you can do:

You can also right-click an appointment to
select...
 Open Chart button to go to that patient's
chart.
 Open Registration to view or change
patient information.
 Open Schedule to change appointment.

Select a Different Date to View

By default your calendar will always display the current date. To view appointments on a different date,
click on the dropdown arrow and select a date or use the up or down arrows on your keyboard in field.

Return to today’s date by clicking on the box to the right of Today date

11
 CHART

Chart Desktop: Manage Secure Messages (Alerts/Flags)

What are Alerts and Flags?

Alerts and Flags are simply secure messages you can send to other AHF clinical staff or other users on
the system. You can also send a flag to yourself as a reminder “to do something” or other notification.

Important note: Flags are not private and are not part of the permanent part of a patient’s chart.

You can view, manage and create Flags from your Chart Desktop or from the Alerts & Flags area by
clicking on the link in the Left Menu in your Chart Desktop. You are also able to create new Alerts or
Flags from the Ribbon in any patient chart.

Like regular email, bold text means a message has not been read. Unlike email, you do not have a “Sent
Mail Folder”.

12
 CHART

Alerts/Flags Pane
Shows a summary view of secure messages called “flags” which can be opened and addressed from this screen

A temporary secure message similar to a Post-it note that does not impact the medical
Flag care or treatment of the patient. Can be applied to a patient’s chart for all users to see or
can be addressed to specific users(s). Once removed, it is gone from the system.

A permanent secure message that serves as an alert for a patient’s chart. These are
important and brief notices about medical care or treatment for a patient. While the
information may reside in a note, the Care Alert provides easy and ready visibility to the
Care Alert information. Can be applied to a patient’s chart for all users to see or can be addressed to
a specific user(s). If removed from a user’s desktop, it remains as a permanent item in the
patient chart.

Examples:
 Patient uses a wheelchair. Please always use exam room #1 or #8 for extra space.
 Patient requires Spanish speaking translator
 Patient is hard of hearing

Pop-Up A Care Alert that pops up on screen each time the patient chart is open.

You can view another provider’s messages or documents. This is helpful for example, in case you are
asked to cover someone eles’s patients while they are away. Click on the link on the left menu for Alerts
and Flags or Documents then click on down arrow or click on binoculars and select a name.

13
 CHART

To Create a New Flag

Click on “New Alert/Flag” in the ribbon. There must be a user’s name in the “To User” field. Complete
other fields as necessary. Click Send to send immediately or Click on Save as Draft to save message at a
later time.

14
 CHART

Chart Desktop: Manage Documents

Documents are the basic parts of a patients chart and contain all the data elements from each patient
encounter. Documents assigned to you will be visible only from your Chart Desktop Summary screen.
The status and the action needed on any document is usually shown on the last two columns of the
screen.

Tools to help you find and sort Documents: Filters and Column Headers

Use Filters to Find Document Types

The filters folder is located in the left pane of the documents section. It contains different pre-defined
filters that will filter and display only the document type that you want to see. For example, if you want
to only see lab reports, select the Lab Report filter.

Use Column headers to sort data in any list

You use filters to find document types but you can also use column headers to sort data that appears in
a list format. Click on any column header once to sort the data in ascending order. Click the column
header again to sort in reverse order.

15
 CHART

Part 2. Writing Notes in CPS: Updating Charts

This chapter explains how to chart in CPS. It introduces the concept “New Document” used to record
clinical notes in CPS. This section will explain the general steps to create a new note associated with a
typical office visit. It includes the following topics:

 What is a New Document?

 4-Steps to edit or update a patient chart
 Document an Office Visit (face-to-face encounters)
 Document Clinical List Changes

16
 CHART

What is a New Document?

In CPS, every time you need to document an encounter or update a chart you must start a
“New Document”. When you are finished with your documentation, you must “end” the
update. You may think of starting a new document like starting a new update.

Office Visit Encounters

Your back-office medical support staff will usually start the office visit encounter (New
Document) for you. Your support staff will enter vitals and other relevant assessments for your
patient during this office visit encounter. When they are finished taking assessments, they will
place the document on hold (administrative hold). When they place the document on hold, it
will automatically appear in the Documents section of your Chart Desktop. This is usually an
indicator that the vitals and triage are complete. However, regardless, of when this new
document appears in your chart desktop, you are free to begin reviewing the patient chart at
any time you want. Follow the general principles of medical documentation to record HPI,
relevant history, physical exam findings, assessment & plan and any other appropriate clinical
information. You can order medications and place orders (service, test or referral) for your
patient during this office visit encounter. When you are finished, you may place this new
document on hold again until you are ready to finalize or sign-it.

As you know, every note you create in a chart has legal significance, once the responsible
provider signs the note the content and clinical date cannot be changed. To make a change to a
signed note, you have the option to “append” or “file in error.” This will be discussed in
separate training.

All notes require your signature to be finalized. After you finish writing a note (new document)
you must “end the document”. “Ending” a document simply means you are finished writing the
note and are ready to sign or finalize it.

17
 CHART

4-steps to edit or update a patient chart:

1. Press New Document to start a new note (start update).

2. Select Encounter Type
3. Complete necessary Encounter Forms (depending on visit type)
4. Press End when you are finished writing a note (end update).

New Document (New Update)

Writing a new office visit note or performing clinical updates to a chart in CPS is handled using a
concept called “New Document”. Documents can only be started while you are inside a
patient’s chart (not from your chart desktop).

Select Encounter Type

When you start a “New Document” you must select an appropriate encounter type, and always
verify the correct clinical date, location of care and make sure your name appears in the
provider field. When this information matches an existing patient appointment, the system will
“associate” your note with the appointment. Associating a note to the correct appointment is a
critical step for proper billing.

Complete encounter/assessments Forms

After you have selected the correct encounter type, the system will preload all the generally
required encounter forms. Depending on the type of office visit, you will be required to
complete some or all of the forms. Which forms you are required to complete, depends on
several factors, including, the type of office visit and your clinic guidelines.

End Update/End Document

Each time you finish writing a note or updating a clinical list or making any changes to a chart,
you must always “end” your update. When you “end” your update, you have the option, among
others, to place the note on “hold”, sign it, discard or route the note to a different provider.

The image below provides a visual representation of the sequence of steps required to start an
update. There are four ways to start a chart update, all require that you must be in the chart.
Select encounter type and verify visit elements are correct in order to associate your note with
the current patient appointment. Complete the necessary encounter forms. When you are
finished writing your note, end the update.

See image below for visual aid.

18
 CHART

Start New Update (you must open chart)

 New Document
 + symbol in any clinical list
 Edit button in flowsheet
 Phone note or Rx Refill note from ribbon

Select Encounter Type Verify /Associate

 New Patient  Clinical Date
 Established  Provider
 AWV  Clinic

Complete Forms Other Forms

 Vitals  HIV History
 HPI  HIV Assessment
 ROS  Substance
 PE  PHQ2/9
 A&P  Etc.
End Update
 Discard
 Sign (finalize)
 Hold (admin hold)
 Route (send to another provider)

19
 CHART

Document an Office Visit (face-to-face encounter)

Follow the steps below to document an office visit. Remember, the chart will not be updated or new
information recorded until you sign/finalize the document.

Open a patient chart and click on New Document button, then select appropriate encounter type.

1 Start a New Document

2 Select Encounter Type

Select correct Encounter

Type and confirm following
three clinical data elements
match the existing
appointment:

 Clinical Date/Time
 Provider
 Location of Care

(appointment turns blue

when associated to note)

20
 CHART

Associate New Note to Appointment

When a check mark appears next to “Associate to existing patient appointment on this Clinical Date”.
This means the new note you are writing and the appointment are now linked. This is an important step
for proper and accurate visit charges.

3 Complete Encounter Forms

Use encounter forms to document the entire office visit. This includes HPI, ROS, assessment, treatment
plan, medications and orders. At the beginning of an office visit, you must select the correct encounter
type template. A template contains different forms. Each form allows you to quickly and systematically
capture data that you want to add into the patient chart. In addition, each form is focused on a
different area of the encounter, for example, Vitals, HPI, HIV HX, ROS etc.

In essence, each form is used to merely capture clinical data. The data does not become part of chart
until you sign it.

There are two layouts you can view: Form or Text

Press the ‘Text” view button to see the progress of the new update or document. Click on the “Form”
button to return to the form view.

Notes:
 Move between forms by clicking on a different form.
 Click on left or right arrow to move to next form or return to previous form.
 Data entered into a form does not become part of chart until the whole document is signed.

21
 CHART

Note: Patients name and other information will appear on the top of the Update screen.

22
 CHART

4 End Update
Once you are finished writing your clinical documentation (entering data into forms). You must end your
document. Ending moves the data you entered into a permanent clinical note with section headings.

Click “End” button to finish creating the document. Once you end the document you can:

 Discard it (if it has not been signed)

 Sign it
 Hold it

A. Discard Document
Select Discard, if you decide the document should be discarded. All the data you entered will be
permanently lost and unrecoverable.

Note: You cannot discard a document if anyone else is editing the same document, if you have signed,
printed, sent orders, or if clinical list changes have been signed during the edit.

B. Sign Document
When you select Sign Document – the system will add your electronic signature. A signed document
becomes permanent legal documentation of the patient chart. Signing also prints paper prescriptions or
transmits electronic prescriptions (e-Prescribe).

Note: You are not able to sign the document if you do not have appropriate signing privileges. You can
also not sign if another user is working in the document or attempting to edit or end it.

C. Hold Document
If the document is not complete or needs additional actions or review, select Hold so you may return to
complete it at a later time. Hold saves your changes and allows you to route it to selected users and
ends the edit.

Note: If you exit the system or leave the Chart module, or if you are logged off automatically after idle
user timeout period, the application saves your changes and places the document On Hold.

23
 CHART

Example of Signed Note

Signed Document (found in patient chart>documents section)

24
 CHART

Document Clinical List Changes

-Refer to CPS Quick-Tip--

25
 CHART

Part 3. Review Patient Charts

This chapter introduces Patient Charts and explains how it is organized into different clinical sections. It
also explains how the summary view automatically opens each time you open the chart and displays a
compact view of five clinical lists. It includes the following topics:

 Open a Patient Chart

 Chart Organization
 Chart Summary
 Chart Summary view (clinical lists)
 Sections Available from Left Menu

26
 CHART

Open a Patient Chart

There are different ways to open the chart from your desktop. You will know when your patient has
arrived when the appointment slot turns blue. The color blue indicates the patient has arrived and
checked-in at the front desk. In addition, a new document will appear in your Que. This document will
usually be titled “New Patient Visit” or “Follow-Up Visit” with a status of “On Hold”.

There are different ways to open a chart:

From your chart desktop:

 Highlight (click-once) appointment then click on Open Chart icon.

1
 Double-click on appointment

 Right-click on appointment and select open chart

From ribbon:
 Search (top half of Find Patient button)
2
 Last Chart Open (bottom half of Find Patient button)

3 From keyboard: CTRL+F Will also open the Find Patient window

Chart Organization

Like old-fashioned paper charts, electronic charts are organized into different sections. Each section can
be accessed by clicking on the Section Name/Link located in the left menu.

By default, the first five sections will automatically appear in the Chart Summary view.

Section Comment
1. Problems (Chart Summary)
2. Medications (Chart Summary)
3. Allergies (Chart Summary)
4. Directives (Chart Summary)
Primary Clinical Info Areas
5. Alerts/Flags (Chart Summary)
6. Documents
7. Flowsheet
8. Orders
9. Histories
 Protocols
 Graphs Secondary Clinical Info Areas
 Handouts
 Registration opens registration for this patient

27
 CHART

Chart Summary

When you open a chart the first view you see is called Chart Summary. This view lets you quickly scan
the patient’s information or drill down to specific details:

Left Menu Chart sections accessible from Left Menu

Primary Clinical Information Areas

1. Problems List
2. Medications List
3. Allergies List
4. Directives List
5. Alerts/Flags List
6. Documents
7. Flowsheet
8. Orders
9. Histories

Secondary Clinical Information Areas

 Protocols
 Graphs
 Handouts

28
 CHART

Chart Summary View (five clinical lists)

You can expand or resize the panes by clicking on the upper left.

You can also set your personal view. Note: You cannot change what lists appear on the chart summary.
You can however, modify certain view characteristics:

 Left-click and hold on the pane edge to resize the pane height or width
 Use drag and drop to change the position of some of the columns in the clinical lists
 Sort the clinical lists by clicking on the column headings

Note: These settings become your personal settings and persist from chart to chart. Once you specify
them in a chart, all charts you view appear with this configuration until you change it.

Sections Available from Left Menu

 Documents
 Flowsheet
 Orders
 Histories
 Protocols
 Graphs
 Handouts
 Registration (this link opens the registration application for this patient)

29
 CHART

Documents
In the patient chart you can review, manage, and act on patient documents, review attachments,
related documents and document contributors, and complete pending orders.

Flowsheet
You can display patient lab results and other clinical data, that you have reviewed and signed off on
(observation values) over a span of time, including the author or source, date and time of entry, units of
measure, normal range of values, and comments or other qualifiers that you add.

You can change the flowsheet view and/or the time scale. Normally, the system automatically adds new
data to display in the flowsheet, each time you sign a lab result report. You can also add data to the
flowsheet manually.

Orders
There are three types of Orders: Service, Test and Referrals (see table below for details)

Order Type Description/Example

Service Billable items given or medical services performed (Office Visits, Injections…)
Procedures that do not require a prior authorization (PA) but results are not
Test immediate (i.e. Lab results, imaging). After results are obtained, the codes may go
to billing or not.
Referrals Require prior authorization (PA) and performed by different provider (specialist).

Histories
The History window allows you to view selected information in a patient's history. The Patient History
view template selects the observations, patient information, and notes associated with a particular
patient to appear in the History window.

A clinical fact or other information about a patient's mental or physical status, such as a lab result, a vital
sign, or the answer to a medical history question.

Protocols
The application supports preventive care by letting you set up protocols. These protocols tell you when
a patient is due for a particular action, based on factors that include sex, age, current problems, and
current medications.

Graphs

Handouts
Not used in production. Print patient information handouts for medications, problems, flowsheet
observations.

Registration
Open registration record for current/active patient you are viewing or currently working on.

30
 CHART

Part 4. Medications and Placing Orders

This chapter introduces Medications, Orders screens and Custom Lists. It also explains the general steps
to prescribe medications using e-prescription. It includes the following topics:

 New Medications (during a visit)

 Placing Orders (during a visit)

31
 CHART

New Medication (during a visit)

To order a new medication during an office visit (New Document):

1. Click on + Medication icon to open New Medication screen.

2. Find medication from a comprehensive list, select “Reference List”.

3. Highlight and Click OK to select.

Note: for electronic RX, choose a medication that includes a retail price.

4. Finish the prescription: Complete the following required fields: Instructions (SIG), Quantity and
Refills

32
 CHART

Note: Make sure correct pharmacy is displayed and has electronic capability. Pharmacies that are able
to accept electronic prescribing are indicated with an asterisk * after the name.

5. Press OK to send RX to pharmacy.

Note: When electronic prescribing method is selected, you must review and confirm new
prescriptions before then can be signed and sent.

To Review Electronic Prescriptions

From Review Electronic Prescriptions window, review the listed prescription(s)

To send to a different pharmacy, click select and select another pharmacy

To exit review window, do one of the following:

1. Select Complete Review. This signs and sends the prescription(s).

2. Select Cancel to return to encounter form and continue updating chart

3. Select Hold Document this will release the clinical list lock, if any, and place the document On Hold
until you are ready to confirm / send the prescriptions.

33
 CHART

Placing Orders (during a visit)

Use the Orders screen to enter new orders for tests, services or referrals. In each case, you must
select a “Custom List” to select the actual items you want to order for a patient. The table below
shows the name of the different custom lists you may use.

Follow the steps below to create and manage orders or referrals during an office visit

1. Click on Orders icon to open the update orders screen.

2. Select a “Custom List” (Pick List) and choose one or more item(s) you want to order.
Available choices are:

To enter an order for… Select this Custom List…

Office Visit Level of Service (E/M Codes) AHF PATIENT ENCOUNTER
Labs LABORATORY ORDERS
Imaging AHF XRAY and IMAGING
Referrals AHF SPECIALITY REFERRALS

3. You must associate a Potential Diagnosis with each order. You must specify a diagnosis from the
Potential Diagnosis list. Add a new diagnosis if it is not already on the list. Time saver: Highlight the
diagnosis first then select an order item from the custom list. This will automatically associate the
same diagnosis with one or more order items you selected.

34
 CHART

4. Enter Order Details (if required). Click on Order Details tab and enter relevant information.

Notes:

1. To add billing modifiers, click Add Modifiers and select one or more modifiers for this order.

2. Add required information in the Instructions field. For example, for an x-ray order, you should
enter an anatomical site and number of views (i.e., “Left Hand PA X2”).

5. Sign the Orders.

35
 CHART

Part 5. Update Chart from the Ribbon: Phone Note / Refill Prescription
Phone Note
Phone Notes are generally used by clinical and non-clinical staff members in the office. The Phone
Note causes a New Document to be created in the patient’s chart. This new document can be routed
to the responsible person/provider for task completion.

There are two ways to start a Phone Note:

Start from the Ribbon

For quick access, the Phone Note has its own icon which appears in the Ribbon area of the patient
chart. When clicked, it bypasses the regular New Document office visit encounter workflow and
instead immediately launches into the new Phone Note document.

Start from New Document

Click on the New Document button, select the Phone Note encounter and complete the required
documentation. This new document can be routed to the correct person/provider for task
completion.

36
 CHART

Refill Prescription (Manual)

--Please refer to CPS Quick Tip—

(Commonly used by AHF Pharmacy staff)

37