MediNotes e EMR Software
MediNotes e Features
Electronic
Patient Folder
You'll never have to hunt
for a patient's folder again. The entire patient history, copies of every
document and more are all completely accessible from the electronic patient
folder.
- Allergies
- Past Medical History
- Treatments/Diagnoses
- Multimedia links to
images, etc.
- Alerts for the patient
- Remarks about the patient
- Patient Overview and
Patient Summary
Default-based
WYSIWYG Templates
Charting
Plus™ templates are color-coded to reflect the current status of the text.
Black Text - This
is simply text which has been hard-coded into the template.
Blue Text - This is a default value
for a pop-up window.
Red Text - This is an optional
pop-up window that can be clicked if needed.
Green Text - This signifies that
the user has activated the dialog and made a change.
Charting
Plus™ templates also, in many cases, contain predefined values. "Default phrases"
provide the text for a "normal" note.
This reduces the time necessary
to create a note because the majority of a "routine" case is already charted.
Our notes reflect a "What
you see is what you get" philosophy. All of the exam charting is done from
one screen. There is no need to switch between screen to enter each section
of information. The note is laid out as you write it.
New Note
from an Old Note
Routine charting or documentation
for follow-ups are a breeze with the New Note from an Old Note command. Simple
choose a patient's past note to use as the basis for the new visit. Typically
these notes are very similar to the previous visit - so very little extra
work is necessary to complete the documentation for the new visit.
ESP
(Electronic Statistical Planning)
Charting Plus™ can analyze
all of the treatments for a certain diagnosis and rank order them for you
when you are writing a note. This ranking makes the common treatments easier
to find and improves the speed of your charting.
Common/Topic/All
History Elements
Charting Plus™ revolutionizes
documentation with a simple and effective way of handling your medical content.
Each history dialog contains a tab for Common, Topic, and All.
Common
- This tab is user-definable.
For Allergies, you are able to show only the allergies that you use frequently
to make your list more manageable.
Topic
- The Topic tab is
simply a categorized tree diagram that allows you to pick your specific history
items from the category headings.
All-
Type in the first few letters of the item that you're looking for, and the
"All" tab will search the database for the history item that matches your
description.
Charting Plus™ includes
History dialogs for: Medical History, Social History, Medications, Allergies,
Family History, Surgical History. Appropriate disciplines will also include:
Immunizations, Growth Charts, OB History, Menses History, and Genetics History.
Integrated
Office Tasks
Charting Plus™ can improve
the flow and efficiency of your office by creating additional documentation
based on the information in your note.
Physician
Referral Letters
In only 4 mouse-clicks
you can create a professional letter to refer a patient, or thank another
physician for their kind referral. The letter includes either the full patient
note, or just the impression and plan sections for their reference.
Patient Instructions
Customized Patient
Instructions can be printed and sent home with the patient regarding their
care.
Patient Letters
Similar to a referral
letter, the patient letter is simply a letter template that can be printed
and sent to your client.
Physicians Orders
When an order has been documented in the note, a worksheet can be
printed to show what the physician has ordered.
Prescriptions
Create a script
right from the program using the extensive medical library. The information
for the script is also included at the bottom of the patient's note, and
in the patient's medications folder for easy and consistent reference.
SuperBill Statements
The Billing Wizard
pulls the billing codes from the dialogs used in the exam documentation.
Simply associate the Diagnoses with the appropriate Treatments, and print
the SuperBill Statement. (Some of the billing interfaces allow a direct
transfer of this information to their program - see
Import section.)
Flexibility
The most
important distinction for Charting Plus™ is the
flexibility. It
is, by
far, the most flexible and user-definable program on the market today. Our
templates are composed of customized dialog boxes that each have a
different set of characteristics. Some are simple text macros, while others
have dynamic slider bars for quickly entering numerical values or anatomical
graphics for describing the location of the condition.
Immunization
History
The Immunization History
dialog is used in General Medicine to complete a immunization record for the
patient. This includes childhood immunizations and travel boosters.
Graphic
Annotator-
NEW for 4.1
The Graphic Annotator
allows the physician to write or draw on the Charting Plus™ graphics and then
store them in the patient's multimedia folder for future reference.
E & M
Wizard
The E & M Wizard makes
short work out of the tedious challenge of E & M coding. Exam elements
in Charting Plus™ have been specially "tagged" so the program can easily count
the number of E & M bullets that have been documented, and then list the appropriate
codes for the visit.
HotSpot
Editor
Charting Plus™ utilizes
many full-color graphics to quickly describe an anatomical location. The HotSpot
Editor allows the user to define and modify these areas, and the text descriptions.
With this tool, existing graphics can be modified by the user, or new images
can be added to the program.
History
Repopulation
Information that has been
added to the patient's history (from a note, or by adding the information
directly to the patient's folder), can be pulled into the history section
of a note.
History
and Physical
- Information available in the patient's history will automatically
be repopulated.
SOAP
- History information
can be added to a SOAP note by simply pressing the HX button in the toolbar.
Office
Text Messaging - NEW for 4.1
Charting Plus now offers
a secure way for medical personnel to discuss confidential patient information
or offer reminders regarding patient care. MediNotes Messenger is a text-based
communication system that is stored and distributed through the program database.
Since it is contained within the secure program, only the recipient (Charting
Plus user) is able to access the message.
Daily
Patient List - NEW for 4.1
The daily patient list
can pull the scheduled appointments into a manageable list for quick access
by the physician. The patient list can be updated manually by office staff,
or can automatically pull in scheduled patients from the
Appointments Pro
and AppointWare electronic
scheduling programs (available through MediNotes Corporation).
Additional
Interfaces - NEW for 4.1
Charting Plus 4.1 now
offers several new interfaces with Patient Accounting packages
(click here for a full list),
as well as, HL7 and XML exporting capabilities.
Accepts
Voice Recognition
Many of the new voice dictation software packages can dictate into Charting
Plus™. This is true with the popular
Dragon NaturallySpeaking™
and IBM ViaVoice
programs. These programs can be purchased separately from Charting Plus™ through
national or local retail electronic chains.
 Other
programs that have the ability to dictate into other windows can be utilized
with Charting Plus™ directly as well. Programs without this ability can also
be used, but would require the user to cut and paste information.
Note
- When looking at voice systems to use in conjunction with Charting Plus™, realize
that the minimum hardware requirements for these programs are usually higher
than those for running Charting Plus™.
Discipline
Specific Features
Growth
Charts (Primary Care)
 A
growth chart can be completed for pediatric patients based on the age, height,
weight, and head circumference. This feature creates a dynamic line graph
representing the charted values over the lifetime of the patient.
Prenatal
Explorer (Primary Care/OB-GYN)
Several dialogs have been
bundled together in what is referred to as the Prenatal Explorer. This feature
of the program includes:
- Estimated Due Date
Calculator
- Prenatal Visit Dialog
- Fetal movement, position,
and heart rate
- Prenatal lab values
- Mother's weight,
blood pressure, and fundal height
Contraception
History (Primary Care/OB-GYN)
The Contraception History
dialog is used to keep a historical description of contraceptive methods used
by the patient. Includes detailed lists of barrier types, and oral contraceptives.
Genetics
(Primary
Care/OB-GYN)
If your patient has a
known genetic disorder, this can be documented using this dialog.
Obstetric
History (Primary Care/OB-GYN)
The Obstetrical History
dialog allows a physician to track all of the past pregnancies for a patient.
This dialog includes:
- Birth weight
- Length of Labor
- Duration of Pregnancy
- Complications
- Delivery Method
- Gender
Call our Healthcare
technology consultants now to discuss your needs. Toll Free
800-303-7838
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