Document View

1. Display the Clinical Inbox: Click the athenaOne logo at the upper left to display the Clinician view of the home page. The Clinical Inbox is in the left pane.
2. Use the View by: menu to sort the documents by type.
3. Click the document type to display a list of documents in that category.
4. Click the document you need.

When you search for a document using the Find tab of the patient chart, you see the first two lines of any internal notes related to the document. If no internal note exists, athenaOne displays the clinical paper form name instead. Encounter documents are the only exception to this rule because athenaOne already displays the clinical paper form name as the title of these documents.

Tip: You can search for lab order documents by their receiver specific name (clinical provider order type name).

1. Display the patient chart: In the text box at the top right of the Main Menu, enter the first three letters of the patient's last name, followed by a comma, followed by the first three letters of the patient's first name. Click the search icon. On the Find a Patient page, click Chart for the patient you need.
2. In the patient chart, click the Find tab at the top of the list of chart tabs on the left side of the screen.
3. Enter search criteria in the text box, or click the Type option to display the list of documents grouped by classification.
   
   Note: Only classifications for which the patient has documents appear in the browse view. For example, if the patient has no Patient cases, that category does not appear.
4. Click the document classification to expand that group.
   Note: The documents within a classification are sorted by date (most recent documents at the top).
5. If available, click the document's sub-classification to further expand the browse view.
6. Click the document name to view it.
7. Search for and open any other documents that you want to display.
   athenaOne creates a new tab for each document and keeps all documents open until you close them or leave the patient chart. You can click a tab to display that document, close a single document tab, or close all open tabs at once.
   Note: You can open as many document tabs as you want, but you cannot open two copies of the same document.

Note: You can edit documents in REVIEW or SUBMITTED status, assigned to PRACTICE or any practice user. You cannot edit a document in this manner if it is classified as Prescription.

1. In the patient chart, click the Find tab at the top of the list of chart tabs to search for and select the document you need.

2. Scroll all the way to the bottom of the document image and click the Edit Document link, located just above the History section. The data entry fields appear. The document classification determines which fields are available for editing.
3. Scroll down to view the document image to determine whether a patient is associated with this document (usually this is not the case). If you find a patient name, enter the patient name in the Patient ID field and enter the patient date of birth in the Patient DOB field; otherwise, leave these fields blank.
4. Review the document image to determine whether it is addressed to a specific provider. If so, select that provider from the Provider list; otherwise, leave the Provider selection blank.
5. Do one of the following:
• If you encountered no problems with this document, select the Data Entry Completed option.
• If you find an error in the document, select the Error Identified option, select an error reason from the list, and select ATHENA from the Assigned To list or search field to send the document back to athenahealth staff.
• If you cannot complete the previous actions, select the Leave in DATAENTRY option.
6. Enter any notes about your actions and this document in the Action Note field. (You can press Return to separate lines of text in long notes.)
7. Click Save to complete the action, or click Save and Next to complete the action and proceed to the next document on your list. To exit the page without saving your changes, click Cancel. The document is assigned the next appropriate status, based on your actions and selections.

Note: You can reclassify any document in REVIEW, SUBMITTED, or CLOSED status, assigned to PRACTICE or to any practice user.

1. In the patient chart, click the Find tab at the top of the list of chart tabs to search for and select the document you need.
2. At the bottom of the document, click view actions.
3. Click the Reclassify document option and select the new classification from the menu.
   Note: If you do not see this action, click more actions. Additional options appear.
4. Click Save. The document task is reclassified according to your selection.

By default, consolidated tasks contain in a single document all lab or imaging results from a patient encounter or order group. If you prefer to consolidate lab and imaging results by patient, instead of by encounter or order group, you can request this option by creating a support case (for more information, see About consolidated tasks).

To open consolidated result tasks

1. Display either the list view or the grid view of the Clinical Inbox.
2. Select Lab/Imaging results.
   Tasks with consolidated results appear with the number of results in parentheses and the results listed. Results are grouped based on the patient, originating encounter or order group, result type (lab or imaging), status, and assigned user.
3. Click a consolidated result task, indicated by a numeral in parentheses before or after an order, to open the consolidated document view.
   
   The title of the document shows the number of results and, when known, the encounter or order group in which they originated. Below the title, you see the number of additional encounter results or orders without results.

To view all results from an encounter or order group from a single document

1. Open a result document.
   If athenaOne has received multiple results for an encounter or order group, a link to the full list of results appears at the top of the document.
2. Click View All [#] Results from [Encounter Type] on [Date].
   • The consolidated document view displays all results that are in the same status and are assigned to the same user as the initial result document. Results that are in other statuses or are assigned to other users appear in the Additional Encounter Results section.
   • If no results are assigned to you, all the results are read-only. To make changes to these results, click each individual document.

To view additional results and pending orders from the same encounter or order group

1. Display the consolidated document view for lab or imaging results: In the Clinician Inbox, click a consolidated result task, indicated by a numeral in parentheses before or after an order.
2. Scroll down to the Additional Encounter Results section.
   Any results for the same encounter or order group that are in a different status or are assigned to a different user appear in a summary form.
   Note: Clicking Select all does not take any action on the additional results when they are in this summary view. However, if you click Show DETAILS and then click Select all, athenaOne also selects any results in the Additional Encounter Results sections that are in the same status.
3. Click Show DETAILS to expand Additional Encounter Results.
   You can edit and select actions only for results assigned to you or another user that are in the same status as the results at the top of the page. Results in a different status are read-only. You can make changes to these results by clicking into each individual document.
   Note: Orders from the same encounter or order group that do not yet have a tied result are listed in the Orders without Results section of the Clinical Inbox.

You can open order documents from within orders in the Assessment & Plan section, allowing you to take actions on the document itself, such as reassigning the order to another user for review or adding an action note to the order history.

Note: For information about the actions you can take on documents, see Document View.

In the order details in the Assessment & Plan section, you can click these links:

• View Document — in orders and in test results that contain patient-supplied results
• View Interpretation Document — in point of care tests that contain interpretation documents
• View Results Document — in point of care tests

Note: You can also locate order documents from the Clinical Inbox or by using the Find tab in the patient chart.

1. In the Exam stage of an encounter, locate the Assessment & Plan section.
   Note: You can also access the Assessment & Plan section from an order group or from the Orders and Results section of the Intake stage of an encounter.
2. Click the order to expand it, and then click VIEW MORE to display links to documents.
   Note: In some cases, you may see the View Document link instead of the VIEW MORE link.
3. Scroll down to the bottom of the order and click View Document, View Results Document, or View Interpretation Document.
   
4. After you edit the document, you can click the X icon to close the document and return to the order in the Assessment & Plan section.

You can record the reason why a patient declined an order in the Assessment / Plan section and in the document view of the order document. When you mark an order as declined, you identify patients as exceptions to clinical quality measures. The reasons for declining an order support clinical quality measure (CQM) documentation and are backed by SNOMED codes.

To mark an order as declined

 

For a demonstration, see this video: How to Mark Orders as Declined

 

You can mark the following types of orders as declined:

• Imaging
• Lab
• Patient information
• Prescription
• Referral (consult)
• Surgery

Orders marked as declined are listed in the encounter summary and full encounter summary, but do not appear in the Medications section or on the Patient Portal (the medications list for a patient represents only those medications that the patient accepted).

1. In the Assessment & Plan section of the encounter, click the order name to display the order details.
2. Click the order to expand it, and then click VIEW MORE to display links to documents.
3. Scroll down to the bottom of the order and click View Document.
   The document view of the order is displayed.
4. Decline — Select the Decline option.
   The Decline Reason field appears.
5. Decline Reason — Select the reason that the patient declined the order from the menu. The reasons available depend on the type of order (see "Reasons for declining orders").
   
   Important: You must select a decline reason from the menu or you will not be able to sign the order.
6. After you edit the order document, you can click the X icon to close the document and return to the order in the Assessment & Plan section.

Reasons for declining orders

 

You can select the following reasons for declining an order, depending on the type of order the patient is declining.

 

Imaging orders

 

The declined reasons menu for imaging orders includes these reasons:

• Contraindicated
• Not indicated
• Not tolerated
• Patient refused
• Treatment changed

 

Lab orders

 

The declined reasons menu for lab orders includes these reasons:

• Contraindicated
• Not indicated
• Not tolerated
• Patient refused
• Religious exemption

 

Patient Information orders

 

The declined reasons menu for Patient Information orders includes these reasons:

• Not indicated
• Not tolerated
• Patient refused
• Religious exemption

 

Prescription orders

 

The declined reasons menu for prescription orders includes these reasons:

• Contraindicated
• Financial problem
• Medical complication
• Not available
• Not tolerated
• Patient refused
• Treatment changed

 

Referral (consult) orders

 

The declined reasons menu for referral/consult orders includes these reasons:

• Contraindicated
• Not indicated
• Not tolerated
• Patient refused

 

Surgery orders

 

The declined reasons menu for surgery orders includes these reasons:

• Contraindicated
• Not indicated
• Not tolerated
• Patient refused
• Treatment changed

 

Vaccine orders

 

The declined reasons menu for vaccine orders includes these reasons:

• Contraindicated
• Financial problem
• Medical complication
• Not available
• Not indicated
• Not tolerated
• Parent refused
• Patient refused
• Religious exemption
• Treatment changed

 

1. Click the athenaOne logo at the upper left to display the Clinician view of the home page. The Clinical Inbox is in the left pane. Use the View by: menu to sort the documents by type. Click the document type to display a list of documents in that category. Click the document you need.
2. Note to pharmacy — Enter the requested prior authorization information for the pharmacy.
   Note: Any information entered in the Internal Notes field is not forwarded to the pharmacy.
3. At the bottom of the document, click the Annotation completed option and select the appropriate submitter (for example, Submit by Provider or Submit by Staff).
4. Click Save.
5. Click the Submit by Athena Fax option and then click Save again.
   Note: The prior authorization is complete when you submit the document by ATHENAFAX, but you can phone the pharmacy to indicate that authorization has been obtained.

When athenaOne receives a lab result or clinical document via interface and is unable to determine which patient the result or document belongs to, it sets the document status to HOLD until you select the correct patient.

Note: athenaOne does not match lab results and clinical documents to patients when the result or document is received by fax.

1. Display the grid view of the Clinical Inbox.
   Note: You must display the grid view of the Clinical Inbox to match interfaced lab results and clinical documents to patients.

To access the grid view of the Clinical Inbox, select the Clinical Inbox option from the Inbox menu.



2. Click a linked number in the Lab/Imaging or Clinical Documents row to display the list of documents.
3. Click a document in HOLD status in the list.
   athenaOne displays up to three patient matches, with the best match at the top of the list.
   
   
4. Review the patient information at the top of the page to find the correct patient record.
5. If one of the suggested patient matches is correct, select it from the list.
6. If none of the suggested matches is correct:
1. Select Find profile to search for a different patient. You can search by patient name, date of birth, Social Security number, phone number, address, or provider group.
   
   
2. In the search results, select a patient.
   Note: If you select a patient who has substantially different demographics than the ones in the document, click OK to confirm your choice.
7. Click Save.

If athenaOne was unable to tie an interface lab result to an order, you can tie the result to the order from the lab result document.

Note: You must have access to the patient chart to tie an interface lab result to an order.

1. Open the interface lab result document.
   The document label selector opens.
   Note: Unless you are a provider, you cannot close the document until the labeling is complete. Providers can close an underlabeled document, but athenaOne automatically sets the document to the PENDINGLABEL status and routes it to the provider or department staff row of the Clinical Inbox for labeling.
2. In the Recent Orders section of the document label selector, select the order that matches the result.
   
3. If a message appears asking whether you want to update the lab and ordering provider fields to match the information in the selected order, click OK.

Note: If the result is an interfaced result, please contact the CSC by selecting Support > Create Case or Call in the Main Menu.

Display the document view of the order

1. Click the athenaOne logo at the upper left to display the Clinician view of the home page. The Clinical Inbox is in the left pane. Use the View by: menu to sort the documents by type. Click the document type to display a list of documents in that category. Click the document you need.

Edit the document

2. Select the lab result tied to the incorrect order.
3. Scroll down to the bottom of the result image, and click Edit Document.
4. If you have open orders, the document label selector opens.
5. Click the order in the Recent Orders section of the document label selector to tie the order to the result document.
6. Click Save.

1. Click the faxed result document in the Clinical Inbox to display the document view.
2. Click Process Document at the bottom of the faxed image to display the Process Document page.
   Note: The Process Document link is available only for faxed documents or uploaded documents that have a file type of .pdf or .tiff.
3. On the Process Document page, click add result (under the Internal Note field).
   The Document Label field appears.
4. Search for and select a label for the document.
5. To add another label, click add result again.
   An additional Document Label field appears.
6. After you finish adding labels to the document, click view actions at the bottom of the page.
7. Select an action and click Save.
8. To review your changes, click document view at the top of the page.
   Tip: You can return to the Process Document page to modify the labels or other information.

To support clinical quality reporting requirements, you can record the result of a diabetic retinal eye exam in faxed or uploaded consult notes and imaging result documents. The document must have one of these labels:

• Diabetic Eye Exam
• Diabetic Ophthalmology Consult Note
• Diabetic Retinopathy Screening
• Neuro-Ophthalmology Consult Note
• Ophthalmology Consult Note
• Ophthalmoscopy (Proc)
• Optometry Consult Note
• Pediatric Ophthalmology Consult Note
• Retinal Eye Exam

The results recorded in these documents support clinical quality measure (CQM) documentation and are backed by SNOMED codes.

To record the results of diabetic retinal eye exams in a consult note or imaging result document, you must have the Clinicals: Edit Chart permission.

1. If you need to upload a faxed imaging document, see To upload an order-related document to attach to a patient chart.
2. Open the document view of the consult note or imaging result from the Clinical Inbox or using the Find tab of the patient chart.
   Note: The document must have one of these labels in the Document Label field: Diabetic Eye Exam, Diabetic Ophthalmology Consult Note, Diabetic Retinopathy Screening, Neuro-Ophthalmology Consult Note, Ophthalmology Consult Note, Ophthalmoscopy (Proc), Optometry Consult Note, Pediatric Ophthalmology Consult Note, or Retinal Eye Exam.
3. Document Result — Enter the result and value in the fields.
1. Result Type — Select Diabetic retinal eye exam.
2. Result Value — Select Positive finding, Negative finding, or Not performed.

Note: If you select Positive finding, the Diabetic Eye Exam quality measure is satisfied for 12 months. If you select Negative finding, the quality measure is satisfied for 24 months. The Not performed option does not satisfy the measure.

4. Click Save.

View, Download, Transmit (VDT) is a Promoting Interoperability quality measure that aims to increase patient involvement in their healthcare by giving patients access to key information in their EHR.

You can exclude a lab result from the VDT measure if "substantial harm may arise from disclosure [of the patient's health information] online."

To exclude the result, display the lab result's document view page and select the Risk of patient harm or legal violation—do not send to patient option in the Patient Access to Results field.

Note: Select this option only if patient or legal harm from displaying this lab result on the Patient Portal is imminent.

If you select this option and then attempt to select the Publish to Portal (no notification) option or one of the ResultsCall notification methods (Send to portal - Email patient, Send to portal - Text patient, or Send to portal - Call patient) in the document actions section, you are prompted to select another option.

For vaccine and medication orders, you can document the National Drug Code (NDC) in:

• Assessment and Plan during a patient exam
• Document view of the order for vaccines and medications that were ordered earlier in the encounter or in a different encounter
• Vaccines section of the patient chart at administration time

Note: You cannot add NDC information in the document view if the order was entered as a prescription.

For vaccines only, athenaOne automatically displays the NDC number in the NDC field when you administer a vaccine (you can change the displayed number, if needed). In addition, you can scan the vaccine barcode to populate the NDC, Lot #, Manufacturer, and Expiry fields in the order (see Scan Vaccine Barcodes for more information).

To add the NDC number to a medication or vaccine order, click the order to expand its details and then click the plus icon in the NDC field.

• If the ordering provider specified the NDC in the order, that NDC appears in the NDC field.
• If the ordering provider did not specify the NDC in the order, you can select one of the NDCs that appear for the vaccine or medication order, or you can search for a different NDC (with or without hyphens) and then select it from the list.
  Important: When selecting NDC numbers, use the NDC on the vaccine or medication itself, not the NDC listed on the package.

The suggested NDCs that appear in the NDC field are based on a feed that athenahealth receives from First Databank, Inc., (FDB) and are determined by the type of vaccine or medication and the dispense form selected in the order.

To ensure CMS compliance with the B(3) electronic prescribing regulation, you are required to select the Diagnosis and ICD-10 Codes. Diagnosis and ICD-10 Codes also appear in the A&P section or order group.

Diagnosis

athenaOne attempts to populate a diagnosis and an ICD-10 code on inbound pharmacy requests and checks the past 15 documents for this data. athenaOne looks back in the chain of renewals. After the initial renewal, requests map back to the previous renewal, rather than the original order. Additionally, if a renewal comes from a denial of a renewal/change request where a new prescription was sent due to EPCS, or from a significant prescription change, it may not be possible to pull the diagnosis or the ICD-10 code from the original order. If this information cannot be found, you must select the diagnosis and ICD-10 code.
Note: Prepopulated diagnoses and ICD-10 codes must be reviewed for clinical accuracy and completeness.

ICD-10 Codes

• If only one ICD-10 code is detected, the ICD-10 Codes field fills automatically.

• If multiple ICD-10 codes are detected, they appear in the ICD-10 Codes menu for selection.

• If no ICD-10 codes are detected, manually select one or more codes for the diagnosis from the ICD-10 Codes menu. Select as many ICD-10 codes as needed. However, athenaOne sends only the first two codes with the medication order to the pharmacy.

When you open more than one document in a patient's chart, athenaOne creates a new tab for each document and keeps all documents open until you close them or leave the patient chart.

Regardless of how you open a document in the patient chart — using the patient document search, clicking a link in a document to open another document, or creating a patient case — you can display, close, and reorder tabs as follows:

• To display a different tab, click the tab that you want to view.
  Note: If you have a large number of open tabs, you see left and right arrows that you can use to scroll from tab to tab.
• To reorder the tabs, click and drag the tab labels.
• To close a tab, click the X on that tab.
• To close all open tabs, click the X at the far right of the page.
  
  

Note: You can open as many document tabs as you want, but you cannot open two copies of the same document. If you leave the chart, athenaOne automatically closes all open documents.

Faxed and uploaded documents that contain multiple lab or imaging results are treated as a single document with multiple labels (one label for each result). The document includes information about each individual test result, and images appears below the test sections.

• The title of a fax image with multiple clinical tests consists of the number of tests in the fax image, followed by the document class (lab or imaging result).
• The document-level information, such as the Provider, Alarm Days, and Patient Access to results, pertains to all results in the document.
• Individual results appear collapsed, with a header for each result. You can click each individual header to expand that test section and view more information.

If you take an action in the document view, the action applies to all test results in the document. For example, if you send the "3 Lab Results" document to NOTIFY status, and the single document contains several test results, athenaOne sends all the test results to NOTIFY status. Because the tests appear on the same sheet of fax paper, athenaOne cannot separate the individual tests and, therefore, cannot send only one test to NOTIFY status.

If your practice receives lab results via interface that include embedded .pdf files, you can see the .pdf file, which contains all the results, and you can display individual results.

• To view one discrete result, click the result name in the list.
• To view all the results in the .pdf file, scroll down to the file.

Note: The .pdf view contains results for completed tests only. For example, if a lab completed five out of 10 tests before sending the results, the .pdf view includes only the results for the five completed tests.

You can view documents of any length in the document view, even documents with hundreds of pages. At the top of each document, you can enter a page number in the Page box and then click outside the box or press Enter to display that page.

For documents longer than 100 pages, you see only 100 pages at a time. To view the next or previous group of 100 pages, click View pages at the top or bottom of each set of 100 pages.

Note: A document with more than a few hundred pages may be slow to load, but the document should appear after several seconds.

Click small or large to change the view size of all pages in a document.

The Actions section appears below the body of the document. You may need to click view actions or more actions to see the available actions.

Click an option to take an action on the document task. The options vary according to the document classification.

Use the Action Note field to clarify the action that you take. You can press Return to separate lines of text in long notes.

Note: You can create and use text macros in the Action Note field of some documents. For more information, see My Text Macros.

You can select the Pin to top option to display the Action Note contents and timestamp at the top of the document, in red font, where they are clearly visible without scrolling down.

Field Reference for Actions

Approve	Approve the document.
Deny	Deny the document. Note: You must select one of the options listed in the denial menu.
Delete	Delete the document. Note: To delete a document, you must have the Clinicals: Delete Document permission. In some cases, the document may need to be approved before you can delete it.
Close	Close the document. Note: In some cases, a document may need to be approved before you can close it.
Submit	Submit the document and place it into a SUBMITTED status.
Annotation completed	Indicate that all annotation for this document is done.
Error Identified Send back to REVIEW	Change the status of this document back to REVIEW, where you can make edits.
Leave in SUBMIT to	Send the document to a user who needs to submit the document.
Leave in REVIEW to	Send the document to a user who needs to review the document.
Submit by Athena Fax	Submit a document by Athena Fax.
Submission Completed	Indicate that the submission of the document is complete using one of these methods: By Paper Print-Out, By Manual Fax, By Phone, or By Athena Fax.
Duplicate	Delete the document because it is a duplicate.
Notify Patient - Normal	Notify the patient about a normal result.
Notify Patient - Abnormal	Notify the patient about an abnormal result.
Reply to Patient via Portal	Reply to the patient via the Patient Portal.
Do Not Send Patient declined	Delete the Patient Care Summary because the patient declined it.
Reclassify document	Reclassify the document under a different document classification.
Athena Error Return to athena	Send the document back to athenahealth because an error was made by athenahealth regarding this document.
Send to HOLD	Place the document into a HOLD status in the Clinical Inbox.
Data Entry Completed	Indicate that the document has finished uploading; place the document into a REVIEW status.
Leave in DATAENTRY to	Send the document for data entry to another user.
Return to Data Entry	Send the document back to data entry.

The History section provides the audit history of the document task. This section lists all the actions taken on the document, with the timestamp, the username of the person who performed the action, and the username of the next person assigned to the document.

Field Reference for History

Date / Time	Date and time of the document action.
Action	Action taken on the document.
Action By	Username of the person who performed the action.
Status	Status of the document after the action was performed.
Priority	Document priority after the action was performed.
Assigned To	Username of the person assigned to the task after the action was performed (ATHENA indicates that athenahealth staff is responsible for the next action).
Action Note	Notes entered for this action.

When you view consolidated document tasks, you can change the clinical provider for batches of orders, vaccines, and prescriptions, as well as for individual tasks.

To change the clinical provider on all orders of a single order type

1. Display the Clinical Inbox: Click the athenaOne logo at the upper left to display the Clinician view of the home page. The Clinical Inbox is in the left pane.
2. Under the Orders/Rxs/Auths column, click a linked number in a row/column intersect to display the orders for the desired users, staff member, or provider.
3. Click an order item with a number in parentheses (this number indicates multiple orders of the same order type).
4. Click the linked Clinical Provider to display the search tool.
5. Check the box Use for all ____ orders for this consolidated document view.
6. Locate the desired clinical provider from the list or by using the search function, and click the select link at the right to update all the orders in the consolidated view.
7. Scroll down to verify that all orders now show the clinical provider that you selected.
8. Click Save at the bottom of the page.

 

Best practices for updating consolidated orders

 

Verify that all orders have the correct clinical provider specified to ensure that orders are not submitted to facilities that cannot fill the order.

 

When you change the clinical provider in the consolidated view for lab, imaging, and other orders, selecting the Use for all __ orders for this consolidated document view option changes the clinical provider only for orders of the same type.

 

Although these three types of orders are displayed in the same consolidated view, the Use for all __ orders for this consolidated document view option works on only one type of order at a time, for example, only on lab orders or only on imaging orders.

 

 

To change the clinical provider for an individual order

1. Display the Clinical Inbox: Click the athenaOne logo at the upper left to display the Clinician view of the home page. The Clinical Inbox is in the left pane.
2. Under the Orders/Rxs/Auths column, click a linked number in a row/column intersect to display the orders for the desired users, staff member, or provider.
3. Click an order item with a number in parentheses (this number indicates multiple orders of the same order type).
4. Click the linked Clinical Provider to display the search tool.
5. Locate the desired clinical provider from the list or by using the search function; then click the select link at the right.
6. Scroll down to verify that only the desired order now shows the clinical provider that you selected.
7. Click Save at the bottom of the page.

athenaClinicals warns you if you are about to edit or delete orders in the document view that have been queued for transmission to the intended recipient (for example, a pharmacy or lab). Orders are queued for transmission when a provider checks the "Sign orders" box and then clicks Save in the encounter, or when the provider selects the "Approve" document action.

To make a change to an order after you send it, you must call the intended recipient to communicate the change and document your change or deletion.

1. View a document that has ever been assigned to ATHENA to submit by fax or interface. (This includes documents that are currently in SUBMIT status, as well as documents in CLOSED status that have already been submitted.)
   Depending on the order type, current status, and your access, you may see a number of document actions that will delete the document or return it to a prior state. For example, a prescription already sent to the pharmacy may have Delete, Reopen, or Error Identified as available document actions.
   
2. If you attempt to save any action that would result in a previously submitted order being deleted or changed, a warning message appears stating "The selected order may have already been received by the recipient (e.g., pharmacy, lab). If you wish to cancel or change this order, you must contact the intended recipient directly. Are you sure that you want to reopen this order?"
   
3. Click OK to reopen or delete the order, or click Cancel to leave the order unchanged.
4. If you identified an error in the order or if you wish to change or cancel it, you must call the receiver (the lab or pharmacy, for example) to communicate your change.
5. Record any changes to the order in the patient chart.

athenaOne alerts you when another user has made conflicting changes to the document that you are working in. When you click Save, the Multi-User Conflicts page appears. You determine the best version of the document to keep, and the document is updated accordingly.

Example scenario

 

Both User A and User B click the Orders/Rxs/Auths work queue of the clinical staff Inbox and notice that patient John Brown needs a renewal of his recent prescription.

1. User A clicks John's order in the worklist to open it.
2. User A clicks the prescription document # link to open the document view.
3. User A updates the prescription document as follows:
   1. Medication to Renew — User A selects ranitidine 300 mg capsule.
   2. Sig — User A selects 1 capsule.
   3. Prescribed Qty — User A enters 5.
   4. User A clicks Save.
4. User B opens John's prescription renewal order at the same time as User A and clicks the prescription document # link to open the document view.
5. User B updates the prescription document as follows:
1. Medication to Renew — User B selects ranitidine 300 mg capsule.
2. Sig — User B selects 3 capsules.
3. Prescribed Qty — User B enters 3.
6. When User B clicks Save, the Multi-User Conflicts page appears.
   The Multi-User Conflicts page displays the prescription renewal that User A saved, as well as the prescription renewal that User B was in the process of saving. The differences in the renewals are highlighted.
   
   
7. If User B determines that her version of the prescription renewal is valid, she clicks the Yours option. If User B decides to accept the prescription renewal made by User A, she clicks the Theirs option.
8. User B clicks OK.

You can use the Report Builder to build reports about clinical documents and save them in the Report Library. From the Choose Report Type tab, under the Type column, select the Clinicals — Document Actions report type and then follow the steps to build a report.

On the Choose Display Columns tab for the Clinicals — Document Actions report type, you can select display columns for your reports from the following column categories:

• Clinical Document — Columns in this category include Document Class, Document Creation Date, and Document ID.
• Clinical Document Action — Columns in this category include Document Action, Document Action Assigned To, Document Action Creation Date, and Document Action Priority (1 = STAT).
• Document Provider — Columns in this category include Approving Provider, Approving Provider Type, Clinical Provider ID, Clinical Provider Tax ID, and Clinical Provider Type.
• Location — Columns in this category include Service Department, Service Department - Type of Bill, and Service Department Place of Service Type.
• Patient — Columns in this category include Patient Deceased Date, Patient ID, and Patient Name.
• Measures — Columns in this category include Document Action Count, Document Count, Provider Document Action Count, and Staff Document Action Count.

User access and permissions

To access the Clinicals — Document Actions report type in the Report Builder, you need the Clinicals user permission and at least one of the following:

• Practice Superuser role
• Report Reader role
• Report: Report Builder: Clinicals permission

• OPEN — Patient encounters awaiting closure by the clinical provider. After a provider closes an encounter, it is removed from the Encounter work queue.
• HOLD — Documents awaiting reclassification, further research, or action by athenahealth or practice staff.
• CLASSIFY — Unknown documents awaiting classification by athenahealth (document is assigned to ATHENA).
• REVIEW — Documents that require review by the clinical provider (lab results, prescription renewals, clinical documents, imaging results).
• NOTIFY — Tasks that require contact with the patient (lab results, prescriptions, imaging results).
• SUBMIT — Any orders or prescriptions that need to be sent to a third-party provider.
• FOLLOWUP — Orders that require time-sensitive follow-up (lab results, imaging studies, referrals).
• PEND — Appointments, orders, and associated tasks that are designated for submission at a later date.
• ADMINISTER — Tasks or orders awaiting administration by clinical staff (vaccines and other medications dispensed in-house).
• PERFORM — Tasks or orders to be performed by clinical staff (labs/imaging performed in-house).
• DISPENSE — Tasks or orders to be dispensed by clinical staff (medication samples).
• SCHEDULE — Tasks or orders to be scheduled by practice staff, for example, return to office (RTO) visits.
• DATAENTRY — Lab result tasks requiring data entry by clinical staff (for in-house labs) or document tasks in queue requiring data entry by athenahealth staff.
• — Tasks marked urgent for immediate action.
• — Tasks flagged for immediate action. These tasks are associated with a patient currently checked in and in the office.
• CLOSED — When a task has been completed, it is removed from the work queue in the Clinical Inbox. An item with a CLOSED status does not appear in the Clinical Inbox.
• DELETED — When a task has been deleted, it is removed from the work queue in the Clinical Inbox and is hidden from any records.