Patient Case

When a patient calls the practice, you can document the call directly in athenaOne while the patient is on the phone and assign it to the appropriate person for resolution. You can access the patient's chart in athenaOne so that you can view and update the patient case in real time, while the patient is on the phone.

1. In the patient chart, click the Menu icon at the upper right and select Create patient case.
   A new patient case opens in DATAENTRY status.
   Note: If you inadvertently create a patient case, select the Delete option and click Save. If you do not click Save before you close the patient case using the X icon at the top right of the document, the case is not deleted and appears in your inbox in DATAENTRY status.
   
   
2. Default Pharmacy — If the Search link appears, click it to set a default pharmacy for this patient. To change the default pharmacy, click the linked pharmacy name to display the pharmacy search tool.
3. Source/Recipient — Select the source of the patient case (for example, Patient, Pharmacy, Lab, Specialist, PCP, or Patient Portal).
   Note: Selecting Patient Portal from the Source/Recipient menu sends the patient case to the Patient Portal for this patient (the message appears on the Messages page of the Patient Portal).
4. Type — Select the type of call (Administrative, Clinical Question, Medical Records, Medication, NewRx, Other, Patient No Show, Referral, Refill, Statement or Billing Question).
   Note: The setting of the Type field is also used when a task assignment override routes a specific task type to a specific practice role.
5. Outbound only — Select this option to indicate that the patient case requires an outbound phone call, but not a response to an inbound call.
6. Provider — Select the provider for whom the call is intended. From this menu, you can see each provider's billed name along with their username or practice role.
   
7. Department — Select the department for which the call is intended.
8. Outside Provider/Lab/Pharmacy — If the call is from an outside provider, lab, or pharmacy:
1. Enter the name of the provider, lab, or pharmacy in the field.
   Note: When you enter three or more letters, matching selections appear.
2. Select the provider, lab, or pharmacy from the list.
   The address, phone number, and fax number for the outside provider appear in the field.
9. Person to Call (if other than patient) — Enter the name of the person to call about this case. This person can be a parent, guardian, or patient advocate, for example.
10. Desired Callback Number — If the caller is the patient or caregiver, select a phone number from the menu. The options in the Desired Callback Number menu include the patient's home, work, and cell numbers, as well as the emergency contact phone number listed for the patient. If the number you need is not in the Desired Callback Number menu, select Other from the menu and enter the phone number in the Other field.
11. Subject — Enter the subject of the case. This subject appears with the patient case task in the Clinical Inbox.
12. Priority — Select This task is urgent if this case requires the urgent attention of the physician. When you select this option, a red bar appears to the left of the task in the list of patient cases in the Clinical Inbox.
13. Alarm Days — If a message is sent to the Patient Portal, the Alarm Days field shows the default amount of time the patient has to read the message; after the alarm expires, the unread patient case is sent back to you for further action (such as calling the patient directly). You can select another value from the menu.
    Note: To use message alarms, the athenaCommunicator Patient Portal must be enabled.
14. Case Description — Enter a detailed description of the patient's complaint or concern.
    Note: To use a text macro in the Case Description field, type a period (".") followed by the beginning, or any part of, the shortcut name, then select the macro you need from the search results.
    
    You can save the text that you enter in the Case Description field as a macro that you can reuse in the Case Description field of other patient cases.
    Note: You can enter only plain text in text macros used in the Case Description field. HTML content — such as bold text, tables, and drop-down lists — is not supported.
1. Enter your text in the Case Description field, then click the star icon to save the text as a text macro for later use.
   
   The macro configuration fields appear.
   
2. Shortcut — Enter a name for the macro (2-50 characters with no spaces). This name will appear in the list of macros available for use.
3. Make available in the current section only — Select this option to limit the macro's availability to the Case Description field in patient cases.
4. Click Edit text to review and edit the full text.
5. Click Save.
15. If you do not need to add orders or generate a patient chart, click Save.
    The patient case is assigned a case number. The case appears as an open task (in REVIEW status) in the provider's Clinical Inbox.
    Note: A Save & Schedule button is also available for users who have Scheduling user permissions.

Save and add orders to the case (optional)

 

After you create a patient case, you can add orders for the patient immediately.

1. Click Save and Add Orders (at the bottom of the page).
   A new order group tab opens.
2. Create the orders as you would from an encounter.
3. Sign the orders.

Save and print the patient chart (optional)

 

After you create a patient case, you can provide the patient with an electronic medical record.

1. Click Save and Generate Chart (at the bottom of the page).
   athenaOne saves the patient case and opens a new chart export tab.

Under Chart Sections

2. You can use the Date Range options to help you locate the documents that you need.
3. To add documents from an entire category, click the category name and then click the right-facing arrow, or double-click the category name.
   Note: Each category name displays the number of available documents in that category in parentheses. If a category does not contain any documents, the category name is gray.
4. To add specific documents within a category, click the plus icon to expand the category, click the specific document, and then click the right-facing arrow to move the document to the Selected Attachments box. You can also double-click the document name to add it to the Selected Attachments box.
   Note: When you hover over a document name in the Available Attachments or Selected Attachments box, a view document link appears. You can click this link to open the document in a new tab.
5. To select multiple categories or documents at once, hold down the Ctrl key and click each category or document that you want to add.

6. Click Export Chart Sections.
   The Record Release Information fields appear, along with a preview of the information to export.
   Note: To change the selected chart sections, click the edit link to add and delete chart sections.
7. Click Save at the bottom of the page.

The status of a patient case (for example, DATAENTRY or REVIEW) is displayed in the Clinical Inbox grid view when you click a row in the Patient Cases column.

1. In the Clinical Inbox, click the linked number in the Patient Cases column.
2. Click the patient case to open it in update mode.
3. Click VIEW ACTIONS at the bottom of the page.
4. Document your response by entering text in the Action Note field.
   Note: To use a text macro in the Action Note field, type a period (".") followed by the beginning, or any part of, the shortcut name, then select the macro you need from the search results.
   
   You can save the text that you enter in the Action Note field as a macro that you can reuse in the Action Note field of other documents.
   Note: You can enter only plain text in text macros used in the Action Note field. HTML content — such as bold text, tables, and drop-down lists — is not supported.
   1. Enter your text in the Action Note field, then click the star icon to save the text as a text macro for later use.
      
      The macro configuration fields appear.
      
   2. Shortcut — Enter a name for the macro (2-50 characters with no spaces). This name will appear in the list of macros available for use.
   3. Make available in the current section only — Select this option to limit the macro's availability to action notes in documents.
   4. Click Edit text to review and edit the full text.
   5. Click Save.
5. Take other necessary actions on the patient case, for example, you can:
   • Update the status of the patient case.
   • Reassign the patient case to another user.
   • Delete the patient case.
6. Click Save.
   Any note entered or action taken appears listed in the History section of the case.
   Note: A Save and Schedule button is also available for users who have Scheduling user permissions.

When your patients send messages to providers using the Patient Portal, these messages appear in the Clinical Inbox as patient cases. You can reply to messages sent by patients from the Patient Portal by opening the patient case.

Note: Patients can attach files to the messages they send from the Patient Portal. When you reply to patient messages, however, you cannot add an attachment to the patient case. For more information, see To view secure message attachments sent by patients from the Patient Portal.

1. In the Clinical Inbox, click the linked number in the Patient Cases column.
   Note: Patient messages sent using the Patient Portal are in the PORTAL inbox row.
2. Click the patient case to open it in update mode.
3. Click VIEW ACTIONS at the bottom of the page.
4. If you are responding to a patient or caregiver message sent using the Patient Portal:
   1. Select Reply to Patient via Portal.
      Note: Leave the Source/Recipient field set to Patient Portal to ensure that your response is sent to the patient or caregiver as a message on the Patient Portal.
   2. Enter the text of your response in the Action Note field. This text is the message that the patient or caregiver will see on the Patient Portal.
      Note: To use a text macro in the Action Note field, type a period (".") followed by the beginning, or any part of, the shortcut name, then select the macro you need from the search results.
5. If you are responding to a message that was not sent from the Patient Portal (the Source/Recipient field is not set to Patient Portal):
   1. Select Reply to Sender.
   2. Enter the text of your response in the Action Note field.
      Note: To use a text macro in the Action Note field, type a period (".") followed by the beginning, or any part of, the shortcut name, then select the macro you need from the search results.
6. Click the Save button.
   The case is assigned to the user who performed the last action on the case.

1. In the Clinical Inbox, click the linked number in the Patient Cases column.
2. Click VIEW ACTIONS at the bottom of the page.
3. Click Save and Add Orders.
   A new order group opens.
4. Add the order as you normally would.
5. In the new order group, athenaOne sets the provider listed in the patient case as the ordering provider, but you can change the ordering provider, if needed.
   Note: If you are a provider, the ordering provider is automatically set to your name instead.
   
   The Visits tab in the patient chart opens automatically with the patient case expanded. You can reference the document on the Visits tab if you need to review it.

To delete patient cases, you must have the Clinicals: Delete Document permission or the Clinicals Deletion role (this role enables you to delete documents, encounters, OB episodes, and order groups).

1. In the Clinical Inbox, click the linked number in the Patient Cases column.
2. Click the patient case to open it in update mode.
3. Click VIEW ACTIONS at the bottom of the page.
4. Click MORE ACTIONS.
5. Select the Delete option and then select a reason from the menu (for example, Duplicate).
6. Click Save.

You can use the My Text Macros and Text Macros pages to create text macros for use in the Case Description field of patient cases.

Note: For instructions on creating a text macro when you create a patient case, see To create a patient case.

1. Display the My Text Macros or the Text Macros page.
   • My Text Macros page: On the Main Menu, click Settings > Text Macros.
   • Text Macros page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Exam, click Text Macros.
2. Click Add new.
   The Add text macro fields appear.
3. Shortcut — Enter a name for the macro (2-50 characters with no spaces). This name will appear in the list of macros available for use.
4. Expansion — Enter the case description text. This text appears in the Case Description field when you select this macro.
   Note: You can enter only plain text in text macros used in the Case Description field of patient cases. HTML content — such as bold text, tables, and drop-down lists — is not supported.
5. Section — Select Patient Case.
   Note: You can also select All to make the text macro available in any macro-enabled field.

6. Users — Select the providers who can use the macro.
   Note: This field appears on the Text Macros page only.

7. Click Add.
   The new text macro appears in the Text Macros list and is available in the Case Description field in patient cases.
8. To use a text macro in the Case Description field, type a period (".") followed by the beginning, or any part of, the shortcut name, then select the macro you need from the search results.

Your patients can send secure messages directly to their providers using the Patient Portal. The messages are routed to the Clinical Inbox (Patient Cases column and PORTAL row), or assigned to a row according to your practice's Task Assignment Overrides settings.

You can reply to messages sent by patients from the Patient Portal within the patient case (see To reply to an open patient case).

Patients can attach files to the messages they send from the Patient Portal. You can view and save these attachments in the patient case (see To view secure message attachments sent by patients from the Patient Portal).

To view secure message attachments sent by patients

 

When a patient (or other portal user) sends a message from the Patient Portal, the message and any attachments appear in athenaOne as a patient case. Attachments become a historical part of the patient case. These patient cases are routed to the Clinical Inbox (Patient Cases column in the PORTAL row) and to the patient chart (Visits tab).

Important: You can view attachments from patients in athenaOne only on your desktop computer.

 

The Attachments section of the patient case lists the files that your patient attached to the message.

• File Name — Name that the patient gave the attached file
• Date/Time Attached — When the file was sent
• Attached By — Name of the Patient Portal user who attached the files

Note: If a patient sends a Patient Portal message without attachments, the following text appears in the Attachments section: No attachments have been added to this case.

 

You can act on patient cases for Patient Portal messages as follows:

• To reply to the message, see To reply to an open patient case.
  Note: When you reply to a patient's message, you cannot add your own attachment to the patient case. If the patient needs a form signed by the provider, such as return to work or return to school letters, see To send a provider-signed patient letter to the Patient Portal.
• To display an attachment, click the file name of the attachment or click View.
• To save an attachment to the patient chart, click Add to Chart.
  Note: athenaOne does not check patient attachments for viruses. When you save an attachment sent by a patient, you can scan the file with your anti-virus software.

To save an attachment from a patient cases to the patient chart

You can save the attachments that patients send from the Patient Portal to the patient's chart in athenaOne.

Note: If a patient attaches more than one document to a message, you must add each attachment one at a time to the chart.

1. In the Attachments section of the patient case, click Add to Chart.
   
   The document appears in DATAENTRY status on the Process Document page.

Identify the document

2. Department — This field defaults to the department that the Patient Portal message was sent to, but you can select another department from the menu.
3. Patient — The patient whose chart you are adding the attachment to.

Classify the document

4. Class — Select a document classification (for example, Clinical Document or Admin - Signed Forms & Letters).
   Note: See Document Classifications for more information about document types and document processing.
5. Document Label — Click Select a document label to open the document label selector and select a document label.
6. If you cannot find an appropriate label after searching the full list of labels:
1. Click the Document label not listed link at the bottom of the selector.
   Note: To suggest additions to the global document label list, open a support case by selecting Support > Create Case or Call in the Main Menu.
2. Internal Note — Enter a description of the document in this field.

Save the attachment to the chart

7. Select the Data Entry Completed option.
8. Click Save and Back to return to the patient case.
   The Add to Chart link is replaced with the text "Added to Chart."
   
   

If you don't save the attachment on the Process Document page

1. If you leave the Process Document page before you save the document, you can find the partially processed document in the Other documents section of the Find tab in the patient chart.
   
   

2. Click Other documents to display them.
3. Click Unknown.
4. Click the document under Unknown to open it (the date that the document was added to the patient chart is shown).
5. Complete the processing of the attachment document on the the Process Document page and save the document.

 

After you save an attachment from a patient case to the chart

After you save an attachment from a patient case to the patient chart, you can search for and display the attachment in the chart. If the attachment is a JPEG, JPG, or PNG image file, the file appears smaller than its actual size. To zoom the file display, click here.

The entire image is displayed in a new window (you do not need to scroll to see the whole image).

 

If the case results in the creation of an order (for example, a prescription), the provider can review the case and click Save and Add Other Orders.

Typically, the provider signs the order immediately, and the order task is then routed to the Signed orders/rxs/auths queue for processing.

When the order is completed, a link to the open patient case appears at the top of the page. The link allows you to toggle back and forth between the case that initiated the order and the order itself. When the order is closed, you can notify the patient and close the patient case.

You can save the text that you enter in the Case Description field as a macro that you can reuse in the Case Description field in other patient cases (click the star icon to the right of the field).

For instructions, see To create a patient case.

To use a text macro in the Case Description field, type a period (".") followed by the beginning, or any part of, the shortcut name, then select the macro you need from the search results.

Text macros in the Case Description field of patient cases differ from text macros used in other macro-enabled fields as follows:

• You can enter only plain text in text macros used in the Case Description field of patient cases. HTML content such as bold text, tables, and drop-down lists is not supported.
• You cannot spell-check text macros used in the Case Description field of patient cases.

For more information about text macros and how to create and use them in the encounter workflow, see Text Macros and My Text Macros.

Dictation

If you use Nuance dictation products, you can use text macros in the Case Description field of patient cases. Make sure to select Dragon Medical Embedded or Dragon Medical One from the Speech to text vendor menu on the User Preferences page. For more information, see Dragon Medical Embedded.

You can view open and closed encounters and patient cases in the Visits and Cases section of the chart. This section lists patient cases in these subclasses: Clinical Question, Medication, NewRx, Other, Referral, and Refill (the subclass is selected using the Type field when you create a patient case).

Note: Patient cases with no subclass are also listed in the Visits and Cases section of the chart.

You can view other subclasses of patient cases — that is, patient cases with a Type value of Administrative, Medical Records, Patient No Show, and Statement or Billing Question — as follows:

• Click the Find tab at the top of the list of chart tabs and search for the case.
• Display the Document Search page: On the Patient Actions Bar, click Communicator, and then click Portal Message History. From the Document Class menu, select Patient Case and then click Search.