Next Gen Training Why is Next Gen So Important? Step-by-Step Vitals Entry Scenarios and Mock Work-ups
Why is Next Gen So Important? Better for the VFC: All the necessary info can be accessed from any VFC site charts used to have to be physically delivered Enables VFC to track their patient metrics such as wait time, outcomes, and population dynamics Better for the Patient: Makes it much more effective when extracting medical data for the examination of possible trends and long term changes in each individual patient
FAQ: Why does VFC use Next-Gen instead of CARE-Connect? Care-Connect is a hospital-based program. So, it works best for larger organizations, such as UCLA and Kaiser. Next-Gen is utilized at smaller clinics, such as VFC!
Step 1: Open Next Gen Open Next Gen Click on EHR"
Step 2: Log In User Name Generally: First Initial + Last Name Password Password will need to be reset DO NOT forget your password DO NOT let anyone else know your password
FAQ: What can t we just use someone else s Next Gen account to enter patient info? This is a HIPAA violation and can be grounds for termination!
Step 3: Check Location Set to current location May vary if you change sites
Step 4: Set Provider Set Provider Will vary by provider
Step 5: Select Patient Click on the Patient button
Step 6a: Patient Look Up Enter the Medical Record Number Click Find
Step 6b: Patient History (continued) Select Correct Patient Click Open
Step 7: Go to Templates On the bottom right-hand corner
Step 8: *Intake This will be your only option as a CA Click OK
Step 9: Confirm Patient s Info Reference the top bar to ensure that you are on the correct patient Use only the first 4 panels! General, Reason for Visit, Allergies & Vital Signs
Step 10: Specialty & Visit Type Specify the "Specialty and "Visit Type"
Step 11: Tracking Click on the compass icon to track patient s visit Update room to Workup Room Update status to With Nursing
FAQ: When should a patient be flagged immediately for staff? All the following circumstances: (Designated as Acutely Ill Adults) 1. Complains of shortness of breath, wheezing or choking: 2. Pulse Oximetry less than 92% on room air 3. Chest pain or pressure 4. Recent drug overdose, ingested poison or recent skin exposure with dangerous chemicals 5. Complains of severe headache starting in last 24 hours or new paralysis of any part of the body 6. Actively bleeding, vomiting blood, or recently passing bright red blood in stool 7. Has an abnormal blood pressure and or pulse: Systolic BP greater than 200mm Hg or less than 80 mm Hg Diastolic BP greater than 110mm Hg Pulse greater than 120/min or less than 50/min 8. Blood glucose: Less than 70 or above 350 9. Hemoglobin is less than 8 10. Temperature is over 102 F
FAQ: Why can I only select 1 2 chief complaints, especially if the patient has several urgent concerns? Our medical providers are required to address every Chief Complaint listed in Next-Gen, so we would like to prioritize only the main reason that the patient is here. Don t worry the provider can always add to the list themselves if needed.
FAQ: What if the patient does not give enough information for the Reason for Visit? For example, what do you do if the patient only tells you that they need a Med Refill? Check the patients History. Check the last visit information that shows the Master IM. View the notes for the last patient visit. Review the Assessment Plan to find out the specific reason for the current patient visit, and confirm with the patient.
Step 12a: Reason for Visit Most common are located on left hand side Other: Search or free text Enter first letter of HPI and hit down arrow * For example type the letter a for asthma Only allows 6 HPIs You can also select Additional / Manage for more options
Step 12b: Reason for Visit List Only 1-2 Reasons Options Include Abdominal Pain Chest Pain Eye Problems Headache Breast Lump Anxiety Etc! Bonus: Which of the above symptoms should be flagged for staff immediately?
Reason for Visit: Women s Progress Notes Specialty: Family Practice Visit Type: Office Visit Click Preventative Exam from the list of Reason for Visit You will recognize the Women s Progress Note is now mapped to the preventative exam option
Step 12c: Reason for Visit HPI Detail Click on the HPI Detail button just left of Reason for Visit in order to add more information only when necessary For example, use this button for patients being seen for a follow-up on a ER or hospital visit Click on onset
Step 13: Ask for Allergies Possible Notes: No known allergies Reviewed, no change Allergies added today Allergen/ Reaction
Step 14: Tobacco Use Must ask for people ages 13+ Options: No/never Yes Unknown *Smoking Status field MUST be populated
Step 14b: Tobacco Use Scroll all the way down to Save & Close
Watch this video to see how to use the configuration wheel to input tobacco history!
FAQ: How do you ask a patient if they are homeless? If you think a patient may be homeless, please advise them in the following manner, The clinic offers services for people that do not have a home Do you have a home?
Entering Homeless Status Homeless Patient Screening: Please be aware that the recent NextGen upgrade eliminated the Homeless Patient Template. In order to complete the required Homeless Patient Screening, please notate Lack of Housing as one of the Reasons for Visit. The Front Desk will indicate HP in details whenever a patient identifies themselves as homeless. Under HPI Detail for Lack of Housing, please enter where the patient is staying. Ex: Street, Beach, Car, etc. This information is important for our Homeless Grant.
Step 15a: Vitals Open panel & click the add button
Step 15b: Vitals Enter the following information: Last Menstrual Period Height (Feet) Height (Inches) Weight (Lbs) + Shoes or w/o BP + Position Pulse Temperature (F) + Site Any other vitals
Watch a video to get a real-time glance at where to add vital signs!
Step 15c: Vitals Notate in the comment section Vitals taken by Add your NAME and CA volunteer For Adult patients: Add under comments section whether or not the patient requested or declined to have a flu shot
FAQ: How do you know when to do a Pulse Ox and Peak Flow for a patient? When you ask the patient for the reason for their visit, always ask the patient if they are diabetic or asthmatic. Pulse Ox are also always done for patients with cough or fevers.
FAQ: What do you do if a patient is 300+ lbs? Each site has a scale designed for patients that are 300+ lbs and/or otherwise unable to use the scale that is provided in the workup rooms. Please ask for assistance.
FAQ: What do you select for Pulse Pattern if you are using the automatic blood pressure machine? Leave the Pulse Pattern option blank.
Step 15d: Vitals Out of Range High BMI Patient is Obese BMI Plan Anything Out of Normal Range Noted in red
FAQ: Where do I check for Alerts? Always check the *Intake page for alerts, such as Westside Partners patients. Click on the alert notice and it will give you the details for the alert.
Step 15e: Vitals Click Save & Close
Step 15f: Vitals (Close Up View) Ensure that all vitals from your visit fit on one line *Orthostatic BPs: Provider may order this after the CA take first set of vitals Includes three tests: Laying down Sitting Standing Erroneous entries cause big problems in our statistical reports and are very hard to delete!
Step 16: Update Tracking Fill In: Appointment Information Room Status: Waiting for Provider Click Save and Close
FAQ: Is it important to note the exam room number (it s inconvenient & takes too much time)? It is OK to input Waiting for provider, if you are not sure of the exam room number.
Step 17: Review and Close If all info is completed and accurate, close the record.
Misc.: Urine tests, Hemoglobin Tests, and Blood Glucose tests Click on Standing Orders
Misc.: Urine tests, Hemoglobin Tests, and Blood Glucose tests Change All to Nurses Orders
Misc.: Urine tests, Hemoglobin Tests, and Blood Glucose tests Select the appropriate diagnosis Enter the appropriate Interpretation Enter the Details Click Add to Superbill Click Place Order
Watch a video to get a real-time look at where to add nursing orders!
FAQ: When do you need to select Submit to Super Bill? Every time you add items on the Standing Orders/Office Services Template, be sure to click Super Bill box. This is how the Clinic is reimbursed for our billable services.
FAQ: When and how do we test patient s glucose monitors? If a patient is in to visit a Diabetes Specialist - Ask if they brought their machine - Administer their blood test on the VFC machine as well as the individual s machine, using the same stick/sample - Note both results in Office Diagnostics
Universal Depression Screening (PHQ-9) Step 1: Determine if screening due 1a. In the Intake template, click Care Guidelines
Universal Depression Screening (PHQ-9) 1b. The Care Guidelines dialog box will appear. Check if the patient is due for depression screening. If Depression Screening is not included, follow the steps below: Click Add/Update.
Universal Depression Screening (PHQ-9) New screen opens. Click the Condition field & select Health Maintenance. Click OK. New screen opens. Click Save & Close Click Yes to Would you like to re-apply the health maintenance protocol? Click Save & Close
Universal Depression Screening (PHQ-9) Step 2: Screen patients due for depression screening 2a. Ask patient to complete PHQ 2 (and if appropriate PHQ 9) paper screener. You may inform the patient: We now ask all of our patients a few questions regarding their mental health each year. Enter the patient s response in NextGen BEFORE the patient is seen by the provider: In Care Guidelines, click PHQ
Universal Depression Screening (PHQ-9) PHQ 2 will appear. Enter the patient s responses. Click Ok Any positive responses will automatically bring PHQ 9. Enter the patient s responses. Be sure to calculate the score. Click Save and Close If the patient declines to be screened: Go to Care Guidelines and double click Depression Screening Update Status to Declined. Click the appropriate reason & click OK. Click Update Remember to type Positive PHQ or PHQ declined as a reason for visit in NextGen.
Depression Screening (PHQ-9) Watch the video to see where to find the PHQ-9 Depression Screening form in Next Gen!
Scenarios and Mock Work-ups Mock Work-ups: Each patient is given a card with a mock work-up scenario. Take turns acting out the appropriate actions given the scenario presented and entering the information into Next Gen.
Congrats on Completing Your Next Gen Training Thank you for coming! We hope to get your new account information within the next few weeks!