User Guide — Encounter Cosignature

Note: Your practice must set up rendering providers on either the Oversight Provider Mapping page or the Cosignature with Encounter Review Setup page. Please do not set up any providers or midlevel providers on both pages.

1. Display the Cosignature With Encounter Review Setup page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Cosignature: Generate Encounter Review, click Cosignature with Encounter Review Setup.
2. Click Add new.
3. Rendering providers — Select one or more rendering providers.
4. % of encounters to be reviewed — Enter the percentage of the residents' encounters for which athenaOne generates an encounter review document.
   This field defaults to 100%. This percentage applies only to the selected providers.
5. Click Save or Save and Add Another.

1. Display the Cosignature With Encounter Review Checklist page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Cosignature: Generate Encounter Review, click Cosignature with Encounter Review Checklist.
2. Click Add new.
3. Name — Enter a name for the checklist item, for example, Complete HPI.
4. Ordering — Enter a number to set a checklist number.
5. Input Type — Select how the item should appear in the checklist. You can configure the item to appear in a drop-down menu, as a radio button, or as a free-text field.
6. Input Class — If you selected Dropdown or Radio, select Yes/No or Custom.
   Note: If you select Custom, you can enter option names.
7. Click Save, or click Save and Add Another to add another checklist item.

When a practice is set up to require the selection of a supervising provider at check-in, athenaOne automatically selects the supervising provider's username in the Move to REVIEW, assigned to field of the Encounter Sign-Off section. You can specify a supervising provider on the Providers page or at Check-in. This functionality is particularly useful for midlevel providers, such as residents, where the resident is not permitted to close encounters and the supervising provider must review and sign the encounter.

Note: Your practice must set up rendering providers on either the Oversight Provider Mapping page or the Cosignature with Encounter Review Setup page. Please do not set up any providers or midlevel providers on both pages.

1. Display the Cosignature With Encounter Review Setup page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Cosignature: Generate Encounter Review, click Cosignature with Encounter Review Setup.
2. Click Add new.
3. Rendering providers — Select one or more rendering providers from the menu.
4. Click Save.

1. In the Sign-off stage of the encounter, click the down arrow next to Sign & Close and select Send for Review.
   
   
2. Enter the supervising provider's name in the search field, and select the provider's name from the matching list.
3. Click Send for Review.

1. Contact the CSC by selecting Support > Create Case or Call in the Main Menu and request the Cosignature: Generate Encounter Review feature.
2. Grant the following permissions to the providers who will use the cosignature feature:
   
• The resident or midlevel provider who requires a cosignature must have the Clinicals: Encounter Cosignature permission.
• The supervising provider must have the Clinicals: Encounter Sign Off and the Clinicals: Oversight Provider permissions.

Note: Granting a provider or midlevel provider both the Clinicals: Encounter Sign Off permission and the Clinicals: Encounter Cosignature permission allows that provider to close encounters, which is generally not the correct setup for residents. The cosignature feature assumes that the resident does not have the Clinicals: Encounter Sign Off permission.

 

3. Cosignature with Encounter Review Setup — Use this page to select the rendering providers who require an encounter review document when using the cosignature functionality.
   Note: After you assign the necessary permissions to your residents or midlevel providers, a cosignature is required for those providers. Entering their names on the Cosignature with Encounter Review Setup page automatically generates an encounter review document for all of these providers' encounters.
   Note: Your practice must set up rendering providers on either the Oversight Provider Mapping page or the Cosignature with Encounter Review Setup page. Please do not set up any providers or midlevel providers on both pages.
4. Cosignature with Encounter Review Checklist — Create a checklist of items to be included when a supervising provider cosigns an encounter. These questions are included at the top of every cosigning encounter review document.

1. The resident performs and documents an encounter.
2. The resident sends the encounter in REVIEW to the supervising provider.
   Note: The resident is responsible for selecting the name of the correct supervising provider.
   athenaOne automatically generates an encounter review document, which appears in the supervising provider's Inbox under Clinical Documents. At the same time, the encounter is routed to the supervising provider for review in the Inbox under Encounters.
3. The supervising provider opens the encounter review document (under Clinical Documents). This document includes a link to the encounter.
   Note: If the encounter is still open, only the encounter link and the questions or checklist configured on the Cosignature with Encounter Review Checklist page appear. If the encounter is closed, the Encounter Summary section also appears.
4. The supervising provider clicks the encounter link in the document to display the encounter.
   
   
5. An Encounter Review section appears in Sign-off, allowing the supervising provider to review the encounter and update the Encounter Review document.
6. The supervising provider uses the questions or checklist to review the resident's work. The supervising provider can also enter comments in the Oversight Comments field. These comments are not visible to the patient.
7. The supervising provider can choose to route the encounter back to the resident for additional action or documentation.
8. If no further action is required, the supervising provider is required to close both the encounter review document and the encounter. These two steps must be completed independently because there could be cases where the encounter can be closed, but the resident and supervising provider continue to use the encounter review document to communicate about the visit or the care that the resident provided.
9. If you need to access the encounter review document later, athenahealth recommends displaying the encounter and opening the document via the Encounter Review section or searching for the document using the Find tab in the patient chart.