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Patient Advisor User Guide

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1. c cccsceessesscesseeesceeeceeceseensecaecaeecaeeeaeeeaeeeseeneeeereneens 28 TO adda Syste a egewesaneds en ob akt niy an bab kon ten f sa kob baay 28 To dd a Subsystem eko baay kaye ed aza a oye see e be pena bean es Benn desen ee 28 Locating a diagnosis in Patient Advisor Setup cccccccscesseecseeseeeeceesceeeceeeeeeenseenaes 29 Setting up Observations ccceccesecssecsseesseeseessceseeeecnseeesecesecaecaaecaeecaeecaeeeseeeeeeeeeeeeeeesenerenreess 30 To add an Observation seeecesesssesecseeeeceseeecsecseesecaeesecnaeeeesaecaeenecaeesesnaeeeeeaeeneeaeeas 30 Updating Systems Subsystems Observations Diagnostic Codes cccesceeseeeteeeeeneeeteeees 32 To update a system subsystem observation or diagnostic COQE eeeereeereree 32 Deleting Systems Subsystems Observations and Diagnostic Codes cesceeseeseeeeeeteeeees 33 To delete a system subsystem observation or diagnostic COQE eereeeeresernes 33 Setting up Treatment Templates ccccccesecseesseeseeeseeeeceeeceseceseceecaecnseceeecaeeeneeeneeneeserenerees 34 To add general information on a new Treatment Template verrereeroeroeoosooes 34 To add an invoice item to a new Treatment Template vvrrerrerrrereretrresrraneoannnanon 36 To add specific item information to a new Treatment TemplAate v eeereeereree 38 To insert general information invoice items or specific item informa
2. errerreeoeoreoororee 81 Patient Visit List ed ote E ao ke tee en ke Ss ae Noe Saeed AEE eat eee Nt 81 Patient CST SUS stats eee kb ayi Sac te ope eh aa de as ant Soupe kata ph ead Saad et hss ene dal enko ya tants let enue 83 To View the Patient CemSusth 2 2 35 ius piyon a a a ieee popo biin 83 Analyzing Patient Advisor Using Reports 85 TAtOAUCHUON ee e Slee echt sec oye este Nee Bade AE Eee ME aD A de 85 Using Filters and And Or Statements ccccccecsceesceeseeeeceeceseceaecesecseecaeeeaeeeeeaeeenes 85 Printing REPOrts sew Gch ce heeties eske an red ee ie dekode eyes S 85 Generating Diagnostic Reminders ccccccceescessceescesecesecesecenecaeeeseceaecaeeeseeeneeeeeeeseeereneeneenaees 86 Before you begin understanding flagged diagnoses 00rrrtrrrerrrorreeroeanoaanoanoonnon 86 To generate diagnostic reminders ccccesceseceseeeseescecseeeseeeseeeeeeeeeeenseceeenseesaeentes 86 Patient Advisor Reports ccsccesccsseesseeseeeseeeseeseeeseeeeeeseeeseceecnaeceaecaeecaeseaeeeeeeeeeeeeeeereneeneeaees 88 Diagnosis Count Report 1 c6 ies ne inenttin ko ine kana fa plesi sesi 88 Diagtiostic Cod Report e a swe see Sets ati wail Bain tabi a wee 88 Instruction Templates Report cccccecessccssecscecseeeseeeeceeeceesceeeesecnseceseeeaecaeeeeeaeeenes 88 Observations Reporters rirerire tien ieor ti E EA ek aste s nen EE tireo des 89 Open Physical Exam PEE EE E E 89 Patient Advisor System Setup
3. 2 On the Treatment Plan tab Pet Health Report Card Treatment Plan Patient File Copies fi a IV Print Item ID s Cancel Iv Print patient picture IV Print prices JV Update Patient Visit List on Post IV Print totals Header message z Footer message ad 14 e Two reports your clients will love A guide to using Patient Advisor e Select the Print option if you want the Treatment Plan to automatically print this will be the default print setting e Enterthe default number of copies to print e Select the Print Patient Picture option if you want the patient s picture to print on the Treatment Plan e If you want to transfer items to the Patient Visit List only after you post an exam select Update Patient Visit List on Post If you do not select this option items are transferred to the Patient Visit List when you save an exam Note Posted exams cannot be changed saved exams can be changed e Select the Print Item ID s option if you want to print your practice s invoice item IDs on the Treatment Plan Do not select this option if you want to keep your practice s item IDs confidential e Select Print Prices if you want prices to print on the Treatment Plan e Select Print Totals if you want totals to print on the Treatment Plan e Enter the Header and Footer message as desired These default messages will print on the top and bottom of the Treatment Plan If necessary you can change the messages when you pri
4. The ear chum and exe corals appear namal and heally Thee i no significani Bi sccumulstion of wax or debris The conformation of ear flap fextemal esr is normal for the reed of the pet The kun ol the san flap and nee san a heakhy mih ro sare of pwan lt maten Presosoulas popiteal inguinal submandibular moh nodes are of nomal size and shape Overall Health Your dog is f t and in excellert hesith a pl sire to examine and have here in our hosptal Nossal We look lawad to seeng yos dog apan al the next checkup Thank you NOTE You can set species specific system templates in Foundation through Species on the Lists menu System ANN X 5 Choose the diagnostic code for this patient Gmm n a E n EE Press F2 in the Code field to select from a list of enabled and active diagnostic codes F gt Page 3 of 3 Close lt lt Back Next Finish kai Exam Wizard Treatment List x Diagnosis z Instructions Instructions to print Monitor response to th w x 6 The instruction headers that will print on Treatment Plan are in the Instructions to Print box Choose Next to proceed and view each instruction header Choose Finish to create the Treatment Plan without reviewing each instruction header AM lel Page 4 of 13 Cancel lt lt Back Finish A guide to using Patient Advisor Introduction to the Physical Exam e 47 7 For each instruction header you will be able to view the infor
5. vi Item ID Description Quantit Amount Disc Tax Staff ID No No za Add Insert Delete Page 5 of 13 Cancel lt lt Back New gt gt Finish 70 e Using the Physical Exam A guide to using Patient Advisor Treatment status buttons The treatment status button the plus sign next to the treatment item is used to indicate the status of the item for this patient Click on the button to change it to a different status The indicates the item was recommended to the client The Fa indicates the item s recommendation was accepted by the client The fa indicates the item was performed on the patient and should be included on the invoice The x indicates the item or service was declined by the client The Bi indicates the item or service was declined by the client and you want it to appear in the patient s history Results e Item notes notes typed in the blue line will not print on the Treatment Plan or appear in the patient s file e The invoice item and matching information appears on the Treatment Plan and in the patient s file e Ifthe diagnosis is marked as linked the invoice items are in the Patient Visit List so they can be transferred to the invoice LL Please refer to the Cornerstone Reference Manual for additional information about items that are placed in the Patient Visit List Related topics Adding an Instruction to the Diagnosis Page 67 Posting the Exam Page
6. 4 Abdomen and Abdominal Organs H E Age Specific Concerns Observations New E Deafness Appearance Weight Temperature C3 Disease of the Pinna J Behavior E Neoplasia LI Blood Disorders 23 Otitis Externa Delete La Breed Predispositions 23 Otitis Intema J Cardiovascular E Otitis Media Close La Chemical and Physical Disorders E Surgery a EE roo 23 No Subsystem Specified seach Eyes H E Gastrointestinal Locate a Hematology diagnosis by a LI Immunology non derm clicking on Infectious Diseases search _ Laboratory Biochemistry Urinalysis C3 Lymph Nodes C Mouth and Teeth Mucous Membranes _ Musculoskeletal J Nervous System 9 Overall Health Respiratory Skin and Hair Coat Spleen vi The window is divided into two panes The left pane or All Folders pane displays all of the body systems in Patient Advisor Contained within these systems are subsystems observations diagnostic codes and instructions As you click a file in the left pane the right pane or Contents pane displays the items associated with the highlighted file SO ii A Plus sign to the left of an icon indicates there are additional items associated with ouble ctiic x r 5 a a aiid that item When you click the plus sign the items within that component appear in the open it left pane A guide to using Patient Advisor Customizi
7. System Laboratory Biochemistry Urinalysis yi Subsystem Undeclared yi l Enabled T Linked Send reminders Exam Message 26 e Customizing Patient Advisor A guide to using Patient Advisor Results e The diagnostic code will be inserted into the Patient Advisor Setup linked to the coinciding system subsystem and can be used in the Physical Exam or the Patient File e The diagnostic codes with the Send Reminders option checked will be flagged diagnostic codes When you want to send reminders based on diagnostic codes you can generate the reminder report based on All Diagnoses or Flagged Diagnoses Related topics Updating Systems Subsystems Observations and Diagnostic Codes Page 32 Deleting Systems Subsystems Observations and Diagnostic Codes Page 33 Introduction to the Physical Exam Page 45 Generating Diagnostic Reminders Page 86 LUI For more information on diagnostic codes please refer to Setting up Diagnostic Codes in the chapter CORNERSTONE LISTS in the Cornerstone Reference Manual A guide to using Patient Advisor Customizing Patient Advisor e 27 Setting up Systems and Subsystems aa Systems designated by the file folder icon are the highest or most general level of diagnoses Patient Advisor comes preprogrammed with the major body systems examined during a patient exam Gea Subsystems designated by the icon of a file folder with two tabs further classify system disord
8. Treatment EE To return to a previous dialog box DisgnosisfEarMies click the Back button Diagnosis ar mites aje x Ear mites are tiny white parasites infecting the ear canals of dogs and cats They are highly contagious frequently infesting whole litters of puppies and kittens Severe ear infections cause injury to the ear canal A dark crusty material is present in the infested ear canals Head shaking and ear scratching are common sians Microscopic and otoscopic examination confirms the presence of ear mites Add Insert Delete Page 5 of 12 Cancel lt lt Back newt gt gt Finish Results e Information entered here prints on the Treatment Plan e The invoice items appear in the Patient Visit List e When you choose Next the wizard proceeds through the Exam Wizard Treatment dialog boxes e When you choose Finish the wizard returns to the Physical Exam where you can change save post or print the Pet Health Report Card and the Treatment Plan for this patient Related topics To determine the instruction to print on the Treatment Plan Page 65 Adding a Treatment to the Diagnosis Page 69 Posting the Exam Page 78 Saving the Exam Page 80 68 Using the Physical Exam A guide to using Patient Advisor Adding a Treatment to the Diagnosis in the Exam Wizard Select the prescription button To open the Exam Wizard Treatment List e Choose Dx Rx from the Physical Exam and proceed throug
9. e Easy to minimize when leaving the room Preventing the patient s information from being seen by other clients Setting up Security Due to its confidential nature specific security instructions are not provided in this book To set up security for each staff member choose Security Setup on the File menu and follow the instructions included separately with Cornerstone Foundation 10 e Before you can use Patient Advisor A guide to using Patient Advisor Two reports your clients will love Two Reports for Client Education One of Patient Advisor s basic premises is providing personalized consistent information to clients Understanding the two documents that Patient Advisor produces for client education is key to helping you complete your setup These documents are the Pet Health Report Card and the Treatment Plan The information that appears on these reports can be set up from and edited in Patient Advisor Setup A guide to using Patient Advisor Two reports your clients will love e 11 Pet Health Report Card The Pet Health Report Card provides details of the physical exam By following a template the provider can systematically examine the patient Each body system can be marked as normal abnormal or not examined 41 19 00 Cornerstone Animal Clinic Page 1 of 2 Pet Health Report Card Client ID 556 Patient ID 556 Gail Abby Patient Name Starbuck 72199 Western Ave Species Canine Breed Retriever Golden Eau Cl
10. 3 Type the information pertaining to the invoice item A check mark must appear beside the information in order for it to print on the Treatment Plan 4 Repeat steps 1 3 to add information on a different invoice item Or Choose OK Note When a specific item information is deleted the item itself will remain If an invoice item is deleted the specific item information will be deleted also In this example the Instruction Heading is Medications We have chosen to Add Specific Item Information This option is used to communicate specific information about the above item such as allergic reactions to drugs specific care instructions or encouragement to return for a recheck 38 e Customizing Patient Advisor Treatment Template Setup x Diagnosis Otitis Externa Medications M Default Duis Externa HB101 vi Description HB101 Nolvasan 1 00 0 00 Evi ve _ Apply 4 drops twice daily Ei Add Insert Delete Save As Cancel A guide to using Patient Advisor Inserting information will place it between items in the template Results e General information will print on the Treatment Plan under the instruction header e The system selects the species specific treatment first if available then the general treatment on the Physical Exam e The treatment items are transferred to the patient visit list when a Physical Exam is completed To insert general information invoice i
11. OR e Select Patient File from the Activities menu select a patient and click on the Physical button To begin a new exam Click on the New button The Exam Wizard will display with default system information To recheck an exam 1 Select the open or posted exam 2 Choose Recheck The Exam Wizard displays the previous exam Add follow up care treatments as necessary A guide to using Patient Advisor Using the Physical Exam e 53 To view an exam 1 Select the exam 2 Choose Select If you selected a closed exam it can only be viewed You cannot change a closed exam If you selected an open exam the Exam Wizard displays the previous exam You can modify the information as needed For more information on modifying an open saved exam refer to page 80 If the patient is checked into the s practice the check in information Patient Exam List LX will appear on the top of the Checked in on 5 6 93 14 32 44 by PSI window ID 308 OYis O Mos 0 00 pounds New Name Spike Pug Neutered Berek i Select broken limbs when you want the Pe EAS en Sa baa tea Close patient to come in to have bandages 5 18 98 5 18 98 Closed Peters Sam L changed or additional x rays 5 18 98 5 18 98 Closed Peters Sam L performed Related topics Beginning the Diagnosis in the Physical Exam Page 55 Modifying Observations on the Physical Exam Page 56 Adding Observation Text Line by Line Page 58 Adding Exam Notes to the Physical
12. Page 1 of 5 Results Exam Wizard System Templates x System template Canine si The following systems have been selected If you d like you can choose which systems should print set the status and change the order feight Temperature Abdomen and Abdominal Organs T Cancel Back Next gt gt Finish The systems are updated for this Physical Exam only The system template will not be changed permanently To change the system template for the practice select System Templates from the Lists menu 74 e Using the Physical Exam A guide to using Patient Advisor Finishing the Physical Exam Overview You have completed the Physical Exam Use the summary dialog box to view the patient s abnormal diagnoses and the diagnostic codes You can use the Treatment tab in the Physical Exam to view the treatment information for this patient You can save or post the exam so it is included in the patient s file Using the Summary Dialog Box to View the Diagnosis The Summary dialog box shows the abnormal diagnoses that you selected on the Physical Exam and the diagnosis information from the Exam Wizard To open the Summary dialog box e Choose Dx Rx from the Physical Exam and proceed through the wizard until you reach the Summary dialog box OR e From the Instruction tab of the Physical Exam right click a treatment or instruction and choose Update to proceed to the Exam Wizard
13. This report shows the staff ID and name diagnostic code and description and the number of times the diagnosis has been used All instances of a diagnosis being recorded for a patient will be included on the report System Template Setup Report The System Template Setup Report shows the body systems marked as default for each system template and the system s default status Sort Order Description Filters Description Body System Status and Default Report Details This report shows the template description body systems for each template the status and default for each body system Body systems print in order specified in System Template Setup 90 e Analyzing Patient Advisor Using Reports A guide to using Patient Advisor Glossary of Terms Diagnosis Assessment The determination of the cause of the animal s condition Final A diagnosis that has been determined or is obvious from the start such as broken leg or hit by a car Instruction Headings An instruction heading is a category that appears on the Treatment Plan There may be certain types of information you always want to appear on the Treatment Plan such as diet exercise medications recheck and symptoms to be concerned about Item Status As invoice items are included in the Physical Exam they can be given a status to appear in the medical history Item Status Accepted After the invoice is generated an item marked as accepted on the Patient Visit
14. 78 Saving the Exam Page 80 A guide to using Patient Advisor Using the Physical Exam e 71 Modifying Treatment Templates At any time through the Exam Wizard you can change the treatment information and attached invoice items to meet the needs of your practice or the needs of the patient To open the Exam Wizard Treatment List e Choose Dx Rx from the Physical Exam and proceed through the wizard e From the Instruction tab of the Physical Exam right click a procedure or instruction and choose Update to proceed to the Exam Wizard Treatment dialog box Choose Treatments to proceed to the Treatment List dialog box To modify treatment information invoice items and specific item information 1 Modify the general information invoice item s and or specific item information as necessary 2 The preprogrammed information will not contain an item ID Press F2 to locate your invoice item ID that matches the treatment If the invoice item does not exist in your database you can add it through Cornerstone Foundation or choose another invoice item You cannot continue through this dialog box without linking the item ID if the diagnosis is marked as linked See the section Linked vs Non linked Invoice Item IDs on page 18 3 Choose Next to continue through the Exam Wizard 4 Choose Finish to return to the Physical Exam dialog box 72 e Using the Physical Exam A guide to using Patient Advisor Changing the Systems to Print During the P
15. Advisor A guide to using Patient Advisor Setting up Diagnostic Codes Patient Advisor uses Diagnostic Codes to identify diagnoses generate Treatment Plans and recommend treatments Note You can also set up diagnostic codes in Cornerstone Foundation and from the Patient Advisor Setup window 3 Timesaver Use the Diagnostic Codes List if you are adding or updating several diagnostic codes If you are adding or updating a few specific diagnostic codes it may be easier to use the Patient Advisor Setup window To open the Diagnostic Codes List On the Lists menu choose Diagnostic Codes You can narrow the list of diagnostic codes which appear by selecting a specific System or Subsystem To open the Patient Advisor Setup window 6 On the Lists menu choose Patient Advisor Setup Click a diagnostic code designated by the microscope icon in the applicable body system or subsystem To add a Diagnostic Code 1 Choose New The Diagnostic Code Setup dialog box appears 2 Type the diagnostic code The code must begin with a letter and is limited to five 5 characters 3 Inthe Hospital Desc box type the hospital description 4 Select the Default Status as Tentative or Final You can change the diagnosis status when you use this diagnostic code Note Do not change the status of the code to inactive You cannot use an inactive diagnostic code for a diagnoses 5 Select the System and or Subsystem relating to this diagnostic code fro
16. Exam Page 64 Diagnosing with the Physical Exam Wizard Page 61 Selecting Instructions to Print on the Exam Wizard Page 65 Adding an Instruction to the Diagnosis in the Exam Page 67 Adding a Treatment to the Diagnosis in the Exam Wizard Page 69 54 e Using the Physical Exam A guide to using Patient Advisor Beginning the Diagnosis in the Physical Exam If you have entered the Exam Wizard through the Patient File the patient s information automatically displays To add exam information 1 The current date displays in the Admit field Press TAB to continue or select a new date Select a Staff ID 3 Selecta Tech ID 4 The default system template appears Use the drop down list to select a different system template if necessary If the system template has been linked to a specific species that template appears See Setting up System Templates on page 43 The default observation text appears based on the patient entered Physical Exam Jack and Cathy Ryan with Keller r Patient information r Exam information ie 555 Keller Admit 104 17 00 Staff John M James w 10 Mos 14 pound i a Da Release 00 00 00 El Tech Laura M Cox x Save Mixed Male e s Close Observations aS System template Canine x Dx Rx Nervous System Bright and alert with a crisp responsive mental attitude Your pet has excellent body control Print Normal posture balance and coordination Its reflexes are
17. List appears Census List x View Patients In Hospital x Sort by Client Name x Check in Staff AN Staff vi Checked in today 3 In hospital 3 Update Room AN Rooms xj Checked out today 2 Scheduled 0 Check out Check in Date Time Reason f ese Dobler Lloyd A 05 10 00 02 30 46 PM 4 Recheck Gail Abby Starbuck 05 10 00 01 11 09 PM Ryan Jack and Cathy 05 10 00 02 06 33 PM 11 Vaccinations LL For more information on the Patient Census please refer to the Cornerstone Reference Manual Z Timesaver If you use Cornerstone s Appointment Scheduler you can select to only view Scheduled Appointments instead of patients in hospital A guide to using Patient Advisor Finishing the Physical Exam e 83 84 e Finishing the Physical Exam A guide to using Patient Advisor Analyzing Patient Advisor Using Reports Introduction Now that you are using Patient Advisor you can begin to generate data to analyze your practice determine your practice s diagnostic history and locate opportunities for growth The data you need is easy to collect with Patient Advisor reports Using Filters and And Or Statements LL Please refer to the chapter ANALYZING YOUR PRACTICE USING REPORTS in the Cornerstone Reference Manual for detailed instructions on using filters and and or statements Printing reports The top of the Report Preview displays the total amount of records in the report the number of records selected e
18. Login dialog box appears In Patient Advisor you also have the option of logging in under your room assignment and the staff member assignment If you choose to login as a particular staff member or in a room the patients assigned to that staff member or room through the patient check in appear as minimized icons in the Patient Advisor window Before you begin e Open Patient Advisor e Add rooms in Cornerstone Foundation To log in to Patient Advisor 1 On the File menu choose Password Entry 2 In the User box type or select your name or ID 3 In the Password box type your password As you type your password asterisks appear in place of the characters 4 Ifyou want to view the patient file icons for patients checked into this room type or select the room in the Room box 5 Ifyou want to display patient files based on the staff member who checked the animal in choose a staff member In the Staff box type or select the staff member 6 Select Display Patients Checked In to have the patients checked into your practice appear as minimized icons on the workstation based on the default 7 Choose OK If you selected Display Patients Checked In the patient files of patients who have already been checked in through Cornerstone Foundation are minimized icons in the Patient Advisor window Note Each subsequent time you log in the system displays the room and staff selected previously To change login information room or staff
19. Physical Exam e 69 To add information for a specific item 1 Inthe Treatment Template Setup dialog box select the treatment Choose Add Spgcific item Choose Specific Item Information information will not be available unless there are items for this diagnosis Type the information for this item Choose Insert to insert the information Choose OK to save the information N On BR W Choose Next to continue through the Exam Wizard To insert treatment information or an invoice item Inserting information or an invoice item will place the new entry above the item where the cursor is currently located 1 Select Insert 2 You can choose to add general information or an invoice item Select invoice item or specific item information and choose OK 3 Select an item ID or type the text in the box for this diagnosis 4 Choose Next to continue through the Exam Wizard Exam Wizard Treatment x Diagnosis Ear Mites si Diagnosis Ear mites aj aj v Description Staff ID Ear Flushing 1 00 15 00 No No vi Ear mites are tiny white parasites infecting the ear canals of dogs and cats They are highly contagious frequently infesting whole litters of puppies and kittens Severe ear infections cause injury to the ear canal A dark crusty material is present in the infested ear canals Head shaking and ear scratching are common sians Microscopic and otoscopic examination confirms the presence of ear mites
20. Report s sssssesesseeseesessreressesresreserstssesreseesesseeeesseseesss 89 Patient Diagnosis Repott ssesssseseesseserseeseesessteressesrseserstssteressestesrestestsseesesseeeseent 89 Patient Diagnosis Status Report scsciromonccnecnonn e 90 Diagnosis by Staff Report ccc c ccccccc scccescesecceecccctcntceceesstdecdecseeedeedtesecdusussecerceeseeseees 90 System Template Setup Report ccecccesecssecsceesseeseeeeceeeceeeeseceeecesecsaecaecneeeeeeseeses 90 Glossary of Terms 91 Index 95 iv e Contents A guide to using Patient Advisor What can Patient Advisor do for my practice Read this manual Please read this manual very carefully before using Patient Advisor It contains information on how to use this program efficiently We recommend using the procedures described here to add update and view medical information contained within the software The client instructions and medical protocols included with Patient Advisor software are intended as convenient starting material for veterinarians to adapt to their own practice policies and procedures VetConnect Systems Inc does not represent or warrant that these instructions or protocols provide either preferred or optimal practice for specific conditions or patients Accordingly these instructions and protocols should be modified to fit the needs of your practice and your clients The responsibility for selecting the appropriate diagnostic and therapeutic regimen for
21. Report 90 System Templates Add 43 Default 43 Systems 12 22 Add 28 Change during Physical Exam 73 Delete 33 Prevent from printing 73 Update 32 Subsystems 22 Add 28 Delete 33 Update 32 T Treatment Plan 13 81 Change order of instructions 65 Header and footer message 15 Instructions to print on 65 Modify from Instructions tab 77 Print option 15 Print Patient Picture on 15 Print prices on 15 Print totals on 15 View 77 Treatment Information 13 69 Treatment Status buttons 39 71 Treatment Templates 22 Add general information on 34 Add invoice item to 36 Add specific item information to 38 Default template 34 36 Delete general information 42 Delete invoice item 42 Insert general information 39 Insert invoice item 39 70 Index e 97 Insert specific item information 39 70 Modifying 72 Open 41 Setting up 34 Update 41 Treatment Type dialog box 35 U Updating matching codes 20 Upload program 6 7 98 e Index A guide to using Patient Advisor IDEXX Cornerstone Support 1 800 695 2877 Sales 1 800 283 8386 Practice what s possible ka kan DO LABORATORIES IDEXX Computer Systems 2536 Alpine Road Eau Claire WI 54703 e mail cornerstoneQ idexx com idexx com comerstone Comerstone and Practice what s possible are trademarks or registered trademarks of IDEXX Laboratories Inc in the United States and or other countries 2005 IDEXX Laboratories In
22. Status Normal x M Print Observations Eves are bright clear and free of discharge Externally the cornea sclera and conjunctiva are EE intact and healthy Internally the ocular lens is healthy and transparent and the iris has a natural color and texture Page 2 of 3 Close lt lt Back New gt gt Finish Deleting observation text Warning Following these steps will delete the observation from Patient Advisor not just from this exam 1 Right click the observation 2 Select the Status normal abnormal or did not examine from the drop down list Choose Update then click on the Search button 3 Select the text to delete Click Delete 4 Choose Finish to return to the Physical Exam Choose Next to continue with the diagnosis Related topics Diagnosing with the Exam Wizard Page 61 Adding Exam Notes to the Physical Exam Page 64 Using the Instructions Tab to View the Treatment Plan Page 77 Posting the Exam Page 78 Saving the Exam Page 80 60 e Using the Physical Exam A guide to using Patient Advisor Diagnosing with the Exam Wizard Once you have viewed the observation text and physically examined the patient you can continue to diagnose the animal Before you begin You must have a Physical Exam started From the Physical Exam choose DX Rx The Exam Wizard Diagnosis dialog box appears Adding a diagnosis in the Exam Wizard 1 Any diagnostic history for this patient displays in the dialog
23. a CheckliSt virevrrerrerrrerrerterreenoraaoooaooanoaaoonaoonnn 6 Installing Patient AAVISOL cecceeseescessceeeceecesecsecssecseecaeecseceaeeneeeseeeaeeeeeeeeserenseenasenseenaeenaes 6 The First Time you Start Patient ACVISOL ccesccsecesecsseesseeseeeseeeseeeeeseenseenseenaeeaeensenaeenaeenaes 6 Bef te you be git 5e w l n Aiee den aati Bethel Hed eee ee 6 To run the Upload prograim e eccceccccescesscesecesecesecseecseecseeeseenseeeeeeeenseenseeneenaeenseenaes 7 Logging into Patient AGVISOL ieies ieii oiei e iei e ii tiie cessed Er CESES EREE e E ESEE 8 To Login to Patient ACViSOL c ccsccesssesseesseeseeeeeeneeeeeeseeneesseenseenaeeaeceaecaecaeecaeeenes 8 Benefits of the Minimized Patient Files ccccccecscesseeeeceseceeceseceeeceeeseeeeeeneeeneeees 10 SHINS UP SECUI eta etone seek teye O pov dofis aa pe step kaka even ae ae ven ees 10 Two reports your clients will love 11 Two Reports for Client Education cecccesccessesseceecseecseecseeeneeeeeeseceseeeeeeeeeeeeeereneeeeeneenaees 11 P t Health Report Card i004 reset adan dit ouvert a r Ea a hal lie danse es 12 Treatment PLAN tcc e sote elec dow cede mee hee sleet wa shee desde acess ened 13 Setting up Patient Advisor Defaults 2 sc As ids dese hth res eee ick wicca see e kaa ve cides soda ogee e 14 Torset the default ic seve cc cecesece o iinei eiii eta i o EEEE N E E 14 Customizing Patient Advisor 17 Intr d ction se
24. any given patient remains with the graduate veterinarian overseeing its care Warning VetConnect Systems Inc assumes no responsibility for patient liability with respect to the use of any information contained within Patient Advisor Your use of the Patient Advisor software is subject to the express terms and conditions of the written license agreement by and between VetConnect Systems Inc and you Patient Advisor and you Patient Advisor is an additional program that enhances Cornerstone Foundation software Patient Advisor is an entirely different approach to the way most veterinarians practice medicine because it e Ismedically driven The software creates information as it guides you through a computerized outline of a standard exam instead of creating information after you have performed the services e Integrates with Cornerstone Foundation You can transfer the services you performed to the invoice add information to medical history and produce prescription labels e sa win win situation for every veterinarian who uses this product and every client who goes to a veterinarian who uses this product A guide to using Patient Advisor What can Patient Advisor do for my practice e 1 Is designed to help you set a new record of pet visits and profits by doubling the average number of pets seen per veterinarian and simultaneously increasing profits Today the average number of pets seen per veterinarian per year is 3000 Gat
25. box e Previous diagnostic history displays in gray e Previous tentative diagnoses display in green e New entries tentative final or ruled out display in black Select the system if necessary Select the Diagnostic Code Press F2 to search for a diagnostic code if necessary The diagnostic code description appears Note The F2 search displays the Diagnostic Code List dialog box From this dialog you can add new diagnostic codes update existing diagnostic codes or delete diagnostic codes 4 8 9 The Reminder button displays if the diagnostic code was defaulted to Send Reminders in the Diagnostic Code setup The Reminder button must display for this diagnostic code to be flagged for reminders Change this button as necessary The current date appears Select a new date if necessary Select the status of Tentative Final or Ruled out The default appears from the diagnostic setup Select the Staff ID To continue to add diagnoses repeat steps 3 6 Choose Next to continue through the Exam Wizard 8 Timesaver If you feel comfortable with the instruction and treatment information linked to a diagnosis you can choose Finish to proceed quickly through an exam A guide to using Patient Advisor Using the Physical Exam e 61 A diagnosis may also be updated Patient Diagnosis Patient information ID Ors 0 Mos 0 00 pounds Name Ralph Boxer Neutered Cancel Code Diamoss te Bone Marrow
26. brisk and sharp Perception of its environment and body position are well tuned Note Ears The ear drum and ear canals appear normal and healthy The is no significant Normal accumulation of wax or debris The conformation of ear flap external ear is normal for the breed of the pet The skin of the ear flap and inner ear is healthy with no signs of parasites of infection Lymph Nodes Prescapular popliteal inguinal submandibular lymph nodes are of normal size and shape Normal Mucous Membranes Gums are a healthy pink color with normal hydration and capillary refill time Normal Overall Health Your dog is fit and in excellent health a pleasure to examine and have here in our hospital Normal We look forward to seeing your dog again at the next checkup Thank you 3 Timesaver If the exam is normal and no diagnoses need to be made choose to post or save Related topics Modifying Observations on the Physical Exam Page 56 Adding Observation Text Line by Line Page 58 Diagnosing with the Physical Exam Wizard Page 61 Adding Exam Notes to the Physical Exam Page 64 Using the Instructions Tab to View the Treatment Plan Page 77 A guide to using Patient Advisor Using the Physical Exam e 55 Modifying Observations on the Physical Exam The observations show the status and the text for each body system The status of the observation can be changed The observation text can be modified as well To change the ob
27. by LAC 10720393 A 1 1 00 DHLPP Booster 3208 for 18 00 by LAC 8 2 99 zl 12 pounds Rows 1 to 11 of 11 i 3 Choose New to perform a new exam Patient Exam List or select a previous exam from the list Checked in on 2 10 00 14 03 42 by James and choose Select or Recheck If the ID 555 10 Mos ads pole patient has been checked into the Name Keller eed Male hospital it will be indicated here also NOTE If the patient is checked in the Admitted Released Status Staff check in information appears above the patient information If the patient is not checked in this information will not appear 4 17 00 Open James John M 46 e Introduction to the Physical Exam A guide to using Patient Advisor Physical Exam Jack and Cathy Ryan with Keller MEE 4 The body systems display based on the default template If there are any mann tl ne N E sut TE abnormal systems right click on the A oun a Release PUTT A Tech aT system and update the status The observation text will automatically change to reflect the system status To modify the observation text double click poswe belence and the text If you modify the observation a you can return to the Physical Exam to change the observation for other body systems or proceed directly to the Diagnosis Choose Dx Rx when the Mucous Membranes Guma ore a healthy pik color with normal hyckation and capilaiy refill time Physical Exam is completed
28. for 10 days Skip 10 days then repeat for an additional ten days Add Insert Delete Save As Cancel In this example the Instruction Header is Medications We have chosen to add an invoice item The check marks indicate the information will print on the Treatment Plan Use the invoice items to indicate services such as Ear Flush or medications such as Tresaderm that need to be included in the treatment for this diagnosis The treatment items appear in the Patient Visit List so they can be transferred to an invoice A guide to using Patient Advisor Customizing Patient Advisor e 37 To add specific item information to a new Treatment Template Specific Item Information applies directly to a particular invoice item and appears on the Treatment Plan You must add the invoice item before adding the item specific information 1 Inthe Patient Advisor Setup window click the treatment template to add the treatment instruction to and choose New The Treatment Templates Setup dialog box appears Click the invoice item that the information applies to and then click the Add button The Treatment Type dialog box appears Note You may not receive the Treatment Type dialog box For example if your cursor is currently located on information specific to an item and you choose Insert the appropriate box automatically appears 2 Specify Specific Item Information and choose OK An item information box appears below the treatment
29. in Patient Advisor Before you begin Print the Instruction Templates Report to see what is currently set up in Patient Advisor and what you need to change for your practice Because this report is so large it can take several hours to print We recommend that you print the report for one system subsystem or diagnosis To update a system subsystem observation or diagnostic code From the Lists menu choose Patient Advisor Setup 2 Click the item you want to change and click Update The item s set up dialog box appears 3 Modify or update the information as necessary and choose OK 4 Repeat steps 2 3 Or choose OK to close the Patient Advisor Setup window Related topics Setting up System Templates Page 43 Setting up Treatment Templates Page 34 Deleting Systems Subsystems Observations and Diagnostic Codes Page 33 Introduction to the Physical Exam Page 45 32 e Customizing Patient Advisor A guide to using Patient Advisor Deleting Systems Subsystems Observations and Diagnostic Codes When you create a system a generic subsystem No Subsystem Specified a generic diagnostic code No Diagnoses Specified and observations Normal Abnormal and Did Not Examine are automatically created The generic items cannot be deleted but will automatically be deleted with the system An observation and or diagnostic code cannot be deleted if it has been used in a patient s file or on a Physical Exam To delete a system al
30. item in the treatment template 3 Choose Treatment to return to the Treatment List dialog box and modify the instructions to print and proceed through the wizard 4 Choose Finish from the Exam Wizard to return to the Physical Exam 5 If changes were made you must save or post the exam to save the changes Related topics Posting the Exam Page 78 Saving the Exam Page 80 A guide to using Patient Advisor Finishing the Physical Exam e 77 Posting the Exam When you post an exam the exam is saved in the patient s medical history and is considered closed After an exam is posted it cannot be modified You can use a posted exam to recheck a patient When you recheck a patient the observation text from the posted exam appears in the Physical Exam Before you begin Complete a physical exam Open a saved exam to be posted To post the exam 1 Use data defaults 2 to set up the standard 3 information such as print or not print and exam 4 messages for this dialog box 5 On the Physical Exam choose Post You can choose to print the Pet Health Report Card and or the Treatment Plan The header and footer information appears automatically as set up in Data Defaults Change the information as necessary If Print Item IDs is selected the invoice item IDs used by your practice will print on the Treatment Plan If Print Prices is selected the individual invoice item s prices will print on the Treatment Plan If Print Pric
31. may not receive the Treatment Type dialog box For example if your cursor is currently located on information specific to an item and you choose Insert the appropriate box automatically appears 10 11 Select an item ID The description appears Use F2 to search for an item ID Type the quantity of the item The amount price updates You can type an item note in the blue box below the item row if necessary This note appears in the treatment template and Patient Visit List only It will not print on the Treatment Plan or appear in the Patient File A check mark must appear beside any general information or invoice item in order for it to print on the Treatment Plan Repeat steps 5 9 to add another invoice item Choose OK 36 e Customizing Patient Advisor A guide to using Patient Advisor Treatment Template Setup x Diagnosis Ear Mites Species IUndeclared Medications E Flushing of ears Tresaderm x Large amounts of discharge wax and debris accompany most ear disease This material build up prevents medications from reaching the problem areas and may inactivate antibiotic medications Therefore a flushing and cleaning of the ear canal prior to therapy is recommended This procedure may require sedation if the ear canal is painful Description olution 15 ml Tresaderm is effective at killing ear mites and is also anti inflammatory as well as antifungal Use four drops in each ear daily
32. select Password Entry from the File menu 8 e Before you can use Patient Advisor A guide to using Patient Advisor Patient Advisor Login Type a user name and password to log on Uef gi Password fo Patient Advisor information Room AllRooms ay Stat ANS W Iv Display patients checked in Results e Each workstation will default to the Login information from the prior session e When you login as All Staff and or All Rooms the files for every patient that has been checked in appear as minimized icons on the Patient Advisor window This is based on the default number set up in Data Defaults e If you have more than one location with a workstation that has Patient Advisor you may want to select the specific room and or staff member assigned to that room This way only those patients assigned to that room and or staff member through the patient check in appear as minimized icons on that workstation BE Pationt Adve ae File Edit Activities Lists Reports Window Help GAETE P em keller Jac EE GS AE Minimized Patient File Icons A guide to using Patient Advisor Before you can use Patient Advisor e 9 Benefits of the Minimized Patient Files e Visual indication of who has been checked into the practice The patient s name is visible in the minimized icon e Displays the client and patient name and the check in time and room assignment e Easy double click access to that patient s medical file
33. the information when and where it is generated e Help determine the treatments based on the diagnosis e Update the patient s medical record e Update the Patient Visit List with the items to be invoiced if the template is set up with invoice items and the diagnosis is set as linked e Prepare documents the client can take home To open the Physical Exam e On the Activities menu choose Physical Exam OR Select the Physical Exam toolbar button OR Click the Physical button from the Patient File 3 Timesaver The most efficient way of using the Exam Wizard is through the Patient File Use the Patient File to view the patient s history and make comments about the current exam Choose the Physical button on the Patient File dialog box to start the Exam Wizard A guide to using Patient Advisor Introduction to the Physical Exam e 51 52 e Introduction to the Physical Exam A guide to using Patient Advisor Using the Physical Exam Overview Once the preliminary information about the patient has been gathered and added to the Patient File you can begin the diagnosis Before you begin Become familiar with the preprogrammed information Make sure you have customized the information to meet your practice standards The Patient Exam List The Patient Exam List appears when you select a patient for the Physical Exam It shows the patient s exam history Before you begin e Select Physical Exam from the Activities menu and choose a patient
34. transferred to the Patient Visit List where you can transfer the items to the invoice through Cornerstone Foundation Enter an item as you would enter an item in the invoice 1 On the Lists menu choose Patient Advisor Setup Select the system subsystem and click on the appropriate diagnosis Under the applicable diagnostic code click the instruction heading that applies to this instruction and choose New The Treatment Template Setup dialog box appears Type a detailed description of this treatment template This description appears in the drop down list in the Exam Wizard Treatments dialog box Select a Species from the drop down list if this instruction only applies to a specific species Select the Default check box to use this treatment template as the default within this header or group of species specific templates for this diagnosis At least one treatment template must be a default or the system will not automatically appear on the Physical Exam A different treatment template can still be selected from the drop down list in the Exam Wizard Treatments dialog box Note Ifyou select the Default check box this treatment template becomes the default and Patient Advisor clears the Default check box of the previous default template 5 6 Click the Add button The Treatment Type dialog box appears Specify Invoice Item and choose OK A treatment item row appears in the Treatment Template Setup dialog box Note You
35. 6 pounds fann A A ae etieverGolien Me Release 00 00 00 Tech Laura M Cox 3 Cancel Observations Instructions Diagnosis E ar Mites v Diagnosis 2318 Ear Flushing 1 00 15 00 Ear mites are tiny white parasites infecting the ear canals of dogs and cats They are highly contagious frequently infesting whole litters of puppies and kittens Severe ear infections cause injury to the ear canal A dark crusty material is present in the infested ear canals Head shaking and ear scratching are common signs Microscopic and otoscopic examination confirms the presence of ear mites Home Care Ear mites are contagious and all contact pets need to be treated Ear mites are not confined to the ears and medications that are used for fleas should be sprayed on the bedding materials to prevent re infestation Keep the ears dry no swimming use a drying solution if the ears become wet or after bathing A drying ear cleanser that creates an acid pH in the ear canal that is antibacterial and antifungal is recommended Use this for maintenance twice weekly and after the ears become wet Additional Information Ear mites live and breed in the ear canals but are not confined to the ear canals Ear mites usually cannot be controlled by vi Modifying the Treatment Plan from the Instructions Tab 1 If you need to change information right click the item 2 Choose Update to return to the Treatment dialog box and modify the instruction or treatment
36. Biopsy 09 w a a La a a a al a al a a Li al a al G al jaa a a al a a a al a Updating a diagnosis 1 through the Patient 3 Diagnosis on the Activities menu Any diagnostic history for this patient displays in the dialog box e Previous diagnostic history displays in gray e Previous tentative diagnoses display in green e New entries tentative final or ruled out display in black On the diagnosis select the status from the drop down box If you update the status to final you are prompted to update the diagnosis Choose Yes The Final diagnosis appears with the current date and the Tentative diagnosis displays in gray Results If the diagnostic code was flagged for reminders the diagnosis appears on the Reminder Report when printed for Flagged Diagnoses If the diagnostic code was not flagged for reminders the diagnosis appears on the Reminder Report only if the report is printed for All Diagnoses When you choose Next the Exam Wizard Treatment List appears giving you the opportunity to view add and or modify the treatment information for this patient The diagnostic code appears in the patient s medical history 62 Using the Physical Exam A guide to using Patient Advisor Related topics Determine the Instruction to print on the Treatment Plan Page 65 Adding an Instruction to the Diagnosis Page 67 Adding a Treatment to the Diagnosis Page 69 Modifying Treatment Template
37. IDEXX Cornerstone TM Practice what s possible rar 717 dd TTA aN LABORATORIES PROPRIETARY RIGHTS NOTICE 1993 2001 VetConnect Systems Inc All rights reserved Information in this publication is subject to change without notice Practice names doctors staff patients clients and data used in examples are fictitious unless otherwise noted No part of this publication may be copied reproduced or transmitted in any form or by any means including without limitation in electronic or mechanical form for any purpose without the express written permission of VetConnect Systems Inc VetConnect Systems Inc shall retain all rights title and interest in this publication and any copies thereof and in all copyright trade secret patent and other intellectual or industrial property rights therein Your use of the software that is the subject of this publication shall be in accordance with the express terms and conditions of a written license agreement by and between you and VetConnect Systems Inc the Agreement Your possession of this publication shall not alter modify or affect the terms of the Agreement in any manner VetConnect Systems Inc shall not be liable for any special direct consequential or incidental loss or damage including but not limited to loss of business profit business interruption loss of business information loss of data loss of equipment or other pecuniary or material loss arising out o
38. List will display in the patient s medical history showing that the recommendation was accepted Item Status Declined A declined item is recorded in the Patient Visit List as being declined by the client Item Status Declined to History After the invoice is generated an item marked as declined to history on the Patient Visit List will display in the patient s medical history showing that the recommendation was declined Item Status Performed After the invoice is generated an item marked as performed on the Patient Visit List will display in the patient s medical history showing that the recommendation was performed A guide to using Patient Advisor Glossary of Terms e 91 Item Status Recommended After the invoice is generated an item marked as recommended on the Patient Visit List will display in the patient s medical history showing the recommended item Observations Observations are symptoms you would be looking for in a normal or abnormal situation for each system Observations are broken down into three categories normal abnormal and did not examine Observations print on the Pet Health Report Card Pet Health Report Card The document that prints with all the system observation information after the Physical Exam has been completed This document was called History and Physical Exam in earlier versions of Cornerstone Physical Exam The dialog box used to determine the diagnosis The exam wizard included in
39. Not Examine and Abnormal observations Observations print on the Pet Health Report Card Species specific Observations designated by the dog icon within an observation type contain observation text for a specific species Observation text indicated by the single paper icon within an observation type are undeclared species abnormal or normal conditions Observations may be up to 4000 characters Only the first 245 characters display in the observation screen If more than 245 characters are included they will be followed by ellipses To view the entire observation highlight the desired observation right click and select Update To add an Observation 1 On the Lists menu choose Patient Advisor Setup Click to select the appropriate body system Double click on the observation icon 2 Click the Normal or Abnormal observation in the system and choose New The Observation Setup dialog box appears with the current system and observation type entered Modify if necessary 3 Ifthis observation is specific to a species select the species from the drop down list next to the Species box 4 Ifyou want this observation to be the default observation for this system and observation status in the physical exam click the Default check box Note There must be one default observation for each system and each species specific observation or the system will not appear on the Physical Exam 5 Inthe Observation Text box type the symptoms y
40. Report 90 Patient Exam List 53 Patient File 46 Add to 50 Introduction to 50 Open 50 View 50 Patient Picture 14 15 Patient Visit List 82 Pet Health Report Card 12 73 81 Print option 14 Print Patient Picture on 15 Physical Exam Add exam notes 64 Begin diagnosis 55 Begin a new exam 53 Change observation status 56 Change observation text 56 Change systems to print 73 A guide to using Patient Advisor Edit observation text 57 Finishing 75 Open 51 Overview 45 51 Recheck an exam 53 Summary 75 Using 53 View 54 Post exam 78 Preprogrammed information 17 Prescription Labels 5 Print Pet Health Report Card 12 73 81 Treatment Plan 13 81 R Recheck 81 Reminders generating diagnostic 86 Reports Client Education Reports 11 Diagnosis by Staff Report 90 Diagnosis Count Report 88 Diagnostic Code Report 88 Instruction Template Report 3 88 Observations Report 89 Open Physical Exam Report 89 Patient Advisor System Setup Report 89 Patient Diagnosis Report 89 Patient Diagnosis Status Report 90 Printing 85 System Template Setup Report 90 Using filters 85 S Save exam 80 Security 10 20 Send reminders checkbox 26 27 Species option 43 Species specific observations 22 30 A guide to using Patient Advisor Species specific treatment templates 22 Specific item information 38 39 70 Status of patient system 12 Summary dialog box 75 System Template Setup
41. Treatment List dialog box Choose Treatments to proceed to the Treatment List dialog box Proceed through the wizard to reach to the Summary dialog box Viewing the Diagnosis Summary 1 If you find information that you want to change choose Back to return to a previous dialog box of the Exam Wizard 2 Ifyou want to finish the Exam Wizard and return to the Physical Exam choose Finish You can post save or print the exam A guide to using Patient Advisor Finishing the Physical Exam e 75 Exam Wizard Summary x Summary Diagnosis 5 10 00 Ear Mites Tentative Page 13 of 13 Cancel lt lt Back Next Related topics Using the Instructions Tab to View the Treatment Plan Page 77 Posting the Exam Page 78 Saving the Exam Page 80 76 e Finishing the Physical Exam A guide to using Patient Advisor Using the Instructions Tab to View the Treatment Plan The Treatment dialog box shows you the treatment information that you selected through the Exam Wizard Ifyou finished the Exam Wizard before going through each dialog box use the Instructions tab to view the Treatment Plan Viewing the Treatment Plan 1 From the Physical Exam select the Instructions tab 2 View the information 3 Return to the Observation tab to complete the exam Z Physical Exam Abby Gail with Starbuck Cixi Patient information Exam information j e Post 1D J556 Starbuck Admit 04 20 00 E Staff John M James a 9 Mos 2
42. aire WI 54703 Weight 26 pounds 715 555 7219 Birthday 7 3 99 Exam Date 4 19 00 Sex Neutered Staff John M James Technician Laura M Cox Appearance Weight Temperature Normal Your dog is bright and friendly It has good body conformation with normal weight and muscle mass for age and breed Hydration amount of fluid in the skin and other tissues and body temperature are completely normal as well Breed Predispositions Normal No specific predispositions to be concerned about at this time Age Specific Concerns Normal No age specific concerns that need to be discussed at this time Continue regular check ups vaccinations flea and parasite control and a high quality diet to optimize your pet s health Behavior Normal No behavioral problems were reported Abdomen and Abdominal Organs Normal Abdomen has a healthy conformation and is free of painful areas The liver bowel loops kidneys spleen and lymph nodes have normal sizes location and consistency EARS ABNORMAL Ear mites be treated as the irritation they cause can lead to more serious ear problems Cardiovascular Normal The heart is strong and healthy Each heart valve sounds normal There are no murmurs abnormal sounds The pulse has a normal rate and strength The pulse has a normal regular rhythm Capillary refill rate is rapid indicating good peripheral circulation Respiratory Normal Respiration is normal All the lung fields sound
43. an Kele Wen DW Sta tet Imes a ra WM m alex there Foes PROT Tech corn PI white parastos necting Uppies and kitans e dete capab Hami ehaking and ma sen eonfirma the presenen of ear mees ned 10 the bars and medications that Keep the eors Swimming ute a drying ti the eart become wet or ater bathing A drying ear cinanses that creates an acid p t in the ene canal that is antibacterial and artitungal is recommended Use is for maintenance twice weekiy and after the ears become wet Additional information Fine mtes fen send brand in tha ear canais bat are not confined to the mar canais Ear mies usualy cannet be controled by Par medioine alone and topical fea SATECO A recomended eny week during et treatment to kil surtace mees as wed Medications 48 e Introduction to the Physical Exam A guide to using Patient Advisor Checking Patients into the Practice Alerts If you want the patients files to automatically be available to you as a minimized icon in Patient Advisor check patients into the practice using Cornerstone Foundation The Check In feature is also available in Patient Advisor Helpful Hints Patient Advisor will frequently check for patients that have been checked in during the day to keep the icons updated For information on setting the number of icons to display see Setting up Patient Advisor Defaults on page 14 If you have workstations in certain rooms specify patients
44. an a po pese bi e anvi sava saa en 67 TOUNSET AN ANS WCAAON a e statues io on kn kok e ja boo ok ok bon a do ik ba iei eais 67 Adding a Treatment to the Diagnosis in the Exam WIZAFd 0Leteriereeorereeoouoseoonoososeoonoone 69 To open the Exam Wizard Treatment List ecccescceseeeseeseceseceeeceeeeneeeseeeeeenseees 69 To add treatment information or an INVOICE ION ee cece eeecneeeeceeeeeeesecaeeeenereres 69 To add information for a specific 1tM eeeeeeccesecesecesecseecseeeseeesecaeeeneeeeeeeeeenseens 70 To insert treatment information or an INVOICE ItCM ee eeeeeeeceeeeeceseeeeeeecaeeeeneeeres 70 Treatment Statuis buttons i e eee den eka at E aE aaner cagacte seceedencasgascodhessnsedaenteces 71 Modifying Treatment Templates 0 2lleeviee tete tee aate kata ae tete tate raae aaa annan nsanssaosanosanosanonaoonaoonnoon 72 To open the Exam Wizard Treatment List ceeceecceseceseceseeeeeeeeeseeeeeeneeeereeeens 72 To modify treatment information invoice items and specific item information 72 Changing the Systems to Print During the Physical Exam cceceeeeseesceeeeeeeceeeeeseenteees 73 To Add a System to print on the Pet Health Report Cardo eee eeseeeeeeeeeeereeeeenees 73 To prevent a System from printing on the Pet Health Report Card 73 Finishing the Physical Exam 75 OVEDVIEW iste ooo wi es ohio heroes kondanen ob rh oe os 75 Using the Summary Dialog Box to Vi
45. articular on the Treatment Plan order the headers appear invoice item can be set in may be changed up to print on the Treatment Plan A guide to using Patient Advisor Two reports your clients will love e 13 Setting up Patient Advisor Defaults Set up the Patient Advisor defaults to preset information for the Pet Health Report Card and the Treatment Plan These defaults can be changed when you print the Pet Health Report Card and the Treatment Plan for a patient To set the defaults From the File menu choose Data Defaults The Exam Defaults dialog box appears 1 Onthe Pet Health Report Card tab Patient Advisor Defaults x Pet Health Report Card l Treatment Plan Patient File Copies fi lal Close IV Print patient picture f Abnormals in red Exam message w e Select the Print option if you want the Pet Health Report Card to automatically print this will be the default print setting e Enterthe default number of copies to print e Select the Print Patient Picture option if you want the patient s picture to print on the Pet Health Report Card e Select the Abnormals in Red option if you have a color printer and want the abnormal observation headings to print in red e Enter the Exam Message to print on the Pet Health Report Card Use the drop down list box to choose from existing messages Messages are set up in Cornerstone Foundation through Billing Messages on the Controls menu
46. ation Respiration is normal AII the lung fields sound clear and healthy and your pet has a normal breathing rate and depth The trachea windpipe is of normal size and sensitivity for the breed Eyes are bright clear and free of discharge The cornea sclera and conjunctiva are intact gl land healthy The lens is transparent and the iris has a natural color and texture The pupils lare normally responsive to light Vision appears normal Eyelid function and conformation is normal Observation List x Eyes are bright clear and free of discharge Externally the comea sclera and conjunctiva Cancel Healthy hair coat and skin No scabs sci parasites irritation or history of itching A recommended Eyes are bright clear and free of discharge The comea sclera and conjunctiva are intact 56 e Using the Physical Exam A guide to using Patient Advisor To edit the observation text Click the observation at the point you want to edit text and type text as needed OR 1 Double click the observation to be changed or right click on the observation and choose Update OR click on the Search button to select a different pre defined observation 2 Choose Finish to return to the Physical Exam or choose Next to continue through the Exam Wizard Related topics Adding Observation Text Line by Line Page 58 Diagnosing with the Exam Wizard Page 61 Adding Exam Notes to the Physical Exam Page 64 Posting the E
47. c All rights reserved 09 65250 00 1
48. can be accessed from the Activities menu in Patient Advisor Patient Visit List Keller olki Owner information Patient information ID Keller 11 Mos Mixed Description Ear Flushing 2318 2613 Tresaderm Solution 15 ml 2319 Ear Taping Li iy IS SIS Hi HY IS IS Is Iv Include recommended IV Include accepted Iv Include performed Owner Jack and Cathy Ayar 14 5 pounds Credit code Cash or Credit Cancel Male Payment Perform 1 00 15 00 TNG No al 04 17 00 g 1 00 17 00 Ne No kali 04 17 00 g 1 00 0 00 No No kali 04 17 00 g No No E No No g No No E Total 32 00 Discounts 0 00 Taxes 0 00 Total 32 00 For more information on the Patient Visit List please refer to the Cornerstone Reference Manual 82 e Finishing the Physical Exam A guide to using Patient Advisor Patient Census To view all of the patients currently checked into your practice at any time use the Patient Census The Patient Census displays client and patient names and IDs the check in dates and times staff member IDs and explanations of visits In addition the Patient Census displays how many patients have checked into and out of the practice for the day You can sort the list by client or patient name date and time staff or the type of visit To view the Patient Census Choose Census on the Lists menu or press F3 or click the Patient Census icon on the toolbar The Census
49. clear and healthy and your pet has a normal breathing rate and depth The windpipe is of normal size and sensitivity for the breed Eyes are kright clear and free of discharge The cornea sclera and conjunctiva are intact and healthy The lens is transparen and the iris has a natural color and texture The pupils are normally responsive to light Vision appears normal Eyelid functign and conformation is normal enonsive mental atude Your net has excellent body control Net ht olanne and e The Pet Health Report Card The patient s status Appropriate observation is organized by body systems displays in parenthesis text will display beneath and subsystems Your practice after the instruction the instruction headings can customize the preloaded heading You can choose based on the status entered systems and the order they between normal abnormal during a physical exam appear and did not examine Your practice customizes pre loaded observation information 12 e Two reports your clients will love A guide to using Patient Advisor Treatment Plan Part of providing excellent medical care is recommending treatment for any abnormal findings The Treatment Plan provides details of any diagnosis and outlines a subsequent plan for treatment 4 19 00 Cornerstone Animal Clinic Page 1 of 1 Treatment Plan Client ID 556 Patient ID 556 Gail Abby Patient Name Starbuck 72199 Western Ave Spec
50. diagnosis VPI Codes Veterinary Pet Insurance codes associated with certain procedures for billing A guide to using Patient Advisor Glossary of Terms e 93 94 e Glossary of Terms A guide to using Patient Advisor Index A Abnormals print in red 14 Alerts 49 B Buttons treatment status 39 71 C Census list 83 Checking patients in 49 Client education reports 11 Customizing Patient Advisor 17 D Data Defaults 14 Default system template 43 Diagnosis Add treatment to 69 Adding in the Exam Wizard 61 Locating in Patient Advisor Setup 29 Summary 75 Updating 62 Diagnosis by Staff Report 90 Diagnosis Count Report 88 Diagnostic Code Report 88 Diagnostic codes 22 Add 25 Delete 33 Update 32 Diagnostic reminders 86 A guide to using Patient Advisor Disclaimer 3 E Enabled diagnostic code 25 Exam message 14 26 Exam notes 64 Exam Wizard 45 Add treatment to diagnosis 67 Adding an instruction to diagnosis in 67 Diagnosing with 61 Selecting instructions to print 65 Exam Add exam information 55 Begin 53 Modify observations on 56 Open 80 Post 78 Recheck 53 81 Save 80 View 54 F Flagged diagnoses 86 Foundation Cornerstone 6 G General information on Treatment Templates 34 39 41 Getting started 6 Installing Patient Advisor 6 Instruction Header List 23 Add 23 Change order of 23 Change print order 65 Instruction Headers 13 22 Instruc
51. e assessed in the Physical Exam and only display the Send Reminders button 4 Under System Information select ALL to generate reminders for diagnostic codes included in all systems Deselect ALL to choose the systems Highlight the systems to include in the diagnostic code search 5 Under Subsystem Information select ALL to generate reminders for diagnostic codes included in all subsystems Deselect ALL to choose the subsystems Highlight the subsystems to include in the diagnostic code search 6 Specify a Range to further break down your search 7 Use Preview to view the information Use the Print button to print the report The printed report will not include all of the information that the text file contains Use the text file to print your reminder postcards or letters through Microsoft Word For more information on printing the reminder report and the reminder postcards or letters refer to USING REMINDERS in the Cornerstone Reference Manual 86 e Analyzing Patient Advisor Using Reports A guide to using Patient Advisor Reminders by Diagnosis CD subsystem miormation Age Specific Concerns Appearance Weight Temperature Behavior Blood Disorders A guide to using Patient Advisor Analyzing Patient Advisor Using Reports e 87 Patient Advisor Reports You can access all ofthe Patient Advisor reports from the Reports menu The following alphabetical list outlines what each report contains Remember When usi
52. e patients more often Increase and provide a standard level of medicine to all clients Allow the client to decline the treatment rather than not recommend products and services at all Ensure quality control through the entire hospital Encourage better client compliance Increase profits 2 e What can Patient Advisor do for my practice A guide to using Patient Advisor Disclaimer We are proud to provide you with the right tools to help make your job easier and your practice more productive IMPORTANT We strongly recommend that you take the time to read this manual before you begin to use Patient Advisor in your practice You should add or change the start up data to meet your particular practice needs Print the Instruction Templates Report to view start up data included with Patient Advisor Refer to page 88 for more information on reports Because this report is so large it can take several hours to print We recommend that you print the report for one system subsystem or diagnosis A guide to using Patient Advisor What can Patient Advisor do for my practice e 3 4 e What can Patient Advisor do for my practice A guide to using Patient Advisor Before you can use Patient Advisor Introduction The Patient Advisor e includes the most up to date diagnostic information available allowing you to get started quickly e easily integrates with Cornerstone Foundation Patient Advisor and the Foundation Patient Adviso
53. ecific instructions and treatments with their treatment instructions with each diagnostic code See page 25 a Instruction Headers Jnstruction Headers designated by the multiple papers icon are linked to specific diagnostic codes These headings with the instruction text from the associated treatment template print on the Treatment Plan See page 23 D Treatment Templates Treatment Templates designated by the single paper icon appear under instruction headers These templates may contain instruction text treatments and treatment instructions See page 34 e Species specific Treatment Templates Species specific Treatment Templates indicated by the dog icon contain treatment templates for a specific species See page 34 22 e Customizing Patient Advisor A guide to using Patient Advisor Setting up the Instruction Header List Basically instructions headers are categories on the Treatment Plan Patient Advisor uses Instruction Headers to e Organize Patient Advisor Setup instruction information and treatments e Determine which and in what order information prints on the Treatment Plan While instruction headers appear in alphabetical order in the Instruction Header List the headers and instructions appear in Patient Advisor Setup and print on the Treatment Plan based on the order assigned in the Instruction Header Order Setup Diagnosis Severe itching and scratching of the ears and head area with excessive black wax M
54. ers Several subsystems are included with Patient Advisor To add a System 1 2 3 4 On the Lists menu choose Patient Advisor Setup Click an existing system or No System Specified and choose New In the Description box type the system description Choose OK The system will be inserted alphabetically Note So that the information you gather stays consistent when you create a new system Patient Advisor automatically creates Normal Did Not Examine and Abnormal categories and a Subsystem file No Subsystem Specified which contains a No Diagnoses Specified diagnosis A system can only be deleted if no information has been linked to the system and it has never been used in a patient s file To add a Subsystem 1 2 3 4 Click an existing subsystem or No Subsystem Specified and choose New The current information for the system displays You can modify as necessary In the Description box type the subsystem description Choose OK The subsystem will be inserted underneath the coinciding system 28 e Customizing Patient Advisor A guide to using Patient Advisor Patient Advisor Setup iol x 4 Abdomen and Abdominal Organs ELI Age Specific Concems f Appearance Weight Temperature H E Behavior 4 4 Blood Disorders H Breed Predispositions 9 Cardiovascular H E Chemical and Physical Disorders sa A Observations 5 Deafness H E Disease of the Pinna 9 Neoplasia 4 Otitis Externa a e Observa
55. es is not selected the invoice items prices will not appear on the Treatment Plan If Print Totals is selected a total for all of the invoice items will be included Choose Post 78 e Finishing the Physical Exam A guide to using Patient Advisor Physical Exam Sample Physical Exam dialog box Related topics The Patient Visit List Printing the Pet Health Report Card and the Treatment Plan A guide to using Patient Advisor Page 81 Page 81 Finishing the Physical Exam e 79 Saving the Exam Use data defaults 2 to set up the standard information such as print or not print and exam A saved exam can be modified and used for a recheck on a patient A saved exam is considered open Ifyou select a saved exam the observation diagnosis and treatment information from the saved exam appears in the Physical Exam Ona recheck the observation text from the saved exam will be defaulted into the Physical Exam Before you begin e Complete a physical exam or open a saved or recheck exam To save the exam 1 On the Physical Exam choose Save You can choose to print the Pet Health Report Card and or Treatment Plan 3 The header and footer information appears automatically as set up in Data Defaults Change the information as necessary 4 IfPrint Item IDs is selected the invoice item IDs used by your practice will messages for this print on the Treatment Plan If Print Prices is selected the individual invoice dia
56. ew the Diagnosis cscceseesseesseesecseeeeeeeeeeeeeesenrens 75 To open the Summary dialog bOX cececceesseessesseeeseeeeeeseceseceaecaecseecaeeeneeeneeneeeeeeees 75 Viewing the Diagnosis SUmmary cccccccsseessessceeseeesceeecesecsaecaecaeecaeeeaeeeeeeeeeeereees 75 Using the Instructions Tab to View the Treatment Plano cece eeeseeeceecneeeeceseeeeesecneeeeeneees 77 Viewing the Treatment Plan ecceessessceescesseeeceesceeecesecesecaecaecseecaeeeaecneeeeeeseeses 77 Modifying the Treatment Plan from the Instructions Tab 77 Posting th EXAM w Sey secede fests ous stil see estes tiga kaka Mi E es Es ee la hess 78 PO POSt tHe s x AM kdk ive ke e desan davis Reese aaa atens 78 Savini Githes EXIM PAS RO A Me A A eee ges ec ee es 80 TOSAVE the exam ve boo v etiae e itn ead saris avi e Yea opa ee be oi po a eee donan 80 A guide to using Patient Advisor Contents e iii Modifying a saved Open exam cecececseesseesceseeeeecesecesecesecsecsaecaeecaeeeseeeeeeeeeeeeeeereeeeeeeeaees 80 Tosumodity ANE BRANI eee oo pike desandan dan acts ke teni asasen din Aa ye E kes on ian te 80 Performing a Recheck ss eee k eze en eee teye peso e bwas pe nee nian wh Ga ede aa ee 80 To petform a recheck aou dekole sedo di saba pou kr sede eR i ah aR het 81 Printing the Pet Health Report Card and the Treatment Plan eee ceeeeseeeecneeerceseeeeeeeenees 81 To print the Pet Health Report Card and the Treatment Plan
57. f or resulting from incorrect irregular and or inconsistent backup procedures CORNERSTONE is a registered trademark and is used under license MICROSOFT and WINDOWS are either registered trademarks or trademarks of Microsoft Corporation in the United States and or other countries All other marks used in connection with products or services referenced herein are trademarks or service marks of the respective owners of such marks 2536 Alpine Road Eau Claire WI 54703 715 834 0355 www vetconnectsystems com Contents What can Patient Advisor do for my practice 1 Readithis Manman S250 n E od add deba ats aa kan ee FRET ka ER gone AS Ra IAIN Nose 1 Patient Advisor and YOU ieissa lokal gone siek eirinn te bees E Gunsyereaseres GeeSbehes 1 Gather Consistent Medical Records cccccscesssessceesceseeeseeesceeceseeesecnaeeaecaeceeeaeeenes 2 Provide Personalized Consistent Information to Clients cccccccccsccecssecesseeeseceees 2 What does this mean for the doctor ceccceceseesseesceeseeeeceeseeseceeceeensecesecaecaeenseenaes 2 Before you can use Patient Advisor 5 Introd ction de zouk otan oi poo b so aa ste ye de ke veni E ad ley E E yo RI ve sepa E EEEE 5 Patient Advisor and the Foundation ccccescecsseesseeseeesceeseeeeceeceseenseceaeenseeeeeaeenaes 5 Patient Advisor and Prescription Labels cccccccesseessesseeesceeeceeeceeceseceseensecseeeseeenes 5 Getting Started with Patient Advisor
58. h the wizard e From the Instructions tab of the Physical Exam right click a treatment or instruction and choose Update or Treatments Before you begin The preprogrammed treatment information must have an item ID linked before you can continue through this dialog box Press F2 to choose your item ID to link to this treatment If the invoice item does not exist in your database you can add it through Cornerstone Foundation See the section Linked vs Non linked Invoice Item IDs on page 18 To add treatment information or an invoice item Adding information or an invoice item will place it as the last item in the dialog box or directly below the focus of the cursor 1 Select Add 2 You can choose to add general information or an invoice item Select invoice item and choose OK Select an item ID The description appears to open the In the Quantity type the quantity to dispense of this item The amount is prescription label up dated dialog box i Apply taxes and discounts as necessary In the blue line type an item note if necessary This note will transfer to the Patient Visit List if the diagnosis is linked 7 Choose OK to save the instruction 8 Choose Next to continue through the Exam Wizard 3 Timesaver At any time during the Exam Wizard you can choose Finish to return to the Physical Exam If information is linked to the diagnoses it appears in the Treatment tab A guide to using Patient Advisor Using the
59. han once if all treatment item IDs are not updated Updating matching codes feature When a user is completing a physical exam and enters an invoice item code in a blank item ID field the system will prompt users with appropriate security access to update all templates with the same description with this same invoice item This feature prevents staff members from accidentally updating invoice items Ifyou have appropriate security access you will then be asked if you want to update all instances of the item with the item ID you chose Choose Yes to update all treatment templates that contain the recommended item or choose No to update only this item on this exam For information on changing your security please contact Cornerstone support Related topics Setting up Treatment Templates Page 34 Updating Treatment Templates Page 41 20 e Customizing Patient Advisor A guide to using Patient Advisor Introduction to the Information included in Patient Advisor Setup All of the preprogrammed information in Patient Advisor can be viewed and edited through Patient Advisor Setup on the Lists menu This window looks and works a lot like Windows Explorer Like Windows Explorer the components in Patient Advisor Setup are organized in a hierarchical structure or tree The observations for the Pet Health Report Card and the instructions for the Treatment Plan are organized under systems and subsystems Patient Advisor Setup ioj x
60. her consistent medical records Records and identifies services you provided as well as services your clients declined Includes customized exam information as it guides the user through each body system Records the information when and where it is generated increasing the accuracy of the medical information gathered Creates an outline of what is to be covered during an exam providing more consistent and thorough exams This formalizes the Standard of Care and empowers your staff Saves your observations so you can use them later as customized exam information Provide personalized consistent information to clients Generates Pet Health Report Cards which enhance your clients understanding and adds value to your services Each document is personalized for the patient and his owner facilitating easy explanation of services to be performed Generates Treatment Plans which provides consistent information to each client and prepares the clients for second visit contingency plans Treatment Plans educate your clients with important information about their pet s health increasing client compliance and responsibility Medically driven client correspondence which reminds on diagnostic codes providing a higher level of care and enhancing the opportunities to see the patient to monitor the chronic condition What does this mean for the doctor If we contribute to the doctor s efficiency the doctor can See more patients Se
61. hysical Exam You can modify the default templates during a Physical Exam To add a System to print on the Pet Health Report Card 1 Right click on a system Choose Systems The systems with a check mark will print on the Pet Health Report Card Select additional systems to print The check mark displays a Ak O N Choose OK to save the changes for this physical exam To prevent a System from printing on the Pet Health Report Card 1 Right click on a system Choose Systems The systems with a check mark will print on the Pet Health Report Card A O N Deselect any systems that you do not want to print on the Pet Health Report Card The check mark will not display 5 Choose OK to save the changes for this physical exam 1 Right click on the system you do not want to print 2 The Print command appears with a check mark This system is defaulted to print 3 Select Print The system will not print on the Pet Health Report Card v Normal Abnormal Did Not Examine v Print Systems Update Diagnose A guide to using Patient Advisor Using the Physical Exam e 73 In this example the Abdomen and Abdominal Organs and Gastrointestinal systems will not print on this patient s Pet Health Report Card p Breed Predispositions p Age Specific Concems 7 Behavior Gastrointestinal 7 Cardiovascular 47 Respiratory Skin and Hair Coat 7 Mouth and Teeth 7 Musculoskeletal
62. i de essai asa re is 50 Viewing and Adding to the Patient File oo ceceececsseesseeeceesceeeceeeeeeceseenseeeenseeaees 50 Introduction to the Physical Exam ccccecccesscssscesecesecesecseecseeeseeeeeeseceeeneenseeeseceaeenseeneeeeeenes 51 To open the Physical Exam bwete ze cc side epi ee voisi e skoba pwen p d che kk ask ride kan pouse 51 Using the Physical Exam 53 OVERVIEW kat ka taa ium brain clint pewon Shanes a Aa ke bb kk kn a e sete ko a ba TEA 53 ThePatient Exam Lista erent Ges anon keen Binh a e me ean kepi 53 TO begin a NEW CXAM a 2 6 ict Asien kota po eas be hen a ea ban a senkant koka s 53 Fo recheck an exam peyel ie aa was ei ea aah a sea ka bak ede 53 ii e Contents A guide to using Patient Advisor To yiey AN ENA ka akte von av dete de sena de E E ked ey sesi ae vs ve de e eee peut 54 Beginning the Diagnosis in the Physical Exain cceccsccssecesecseeeseeeeeeseeeeeeeeceeeeneeneeneeneees 55 Todd exam information on peze eko ank arin Sheen ete ot 55 Modifying Observations on the Physical Exam ccccsccssessecsseeseeeeeeeeeeeeeeeeceeeeeeeeneeeeenaees 56 To Change the Observation Status ccccceeseescssscesceescesecesecesecaecseecaeeeaeeseeeeeeeerees 56 To Change the Observation Text ccccccsccesseessessceesceeeceecesecaeceeeeseenaeceaeceeeneeeneeaes 56 To Edit the Observation Text 0 s ecsssesesoessseeevencnerenseneronesenvecsneneneneneeseneneneesores 57 Adding Observation Tex
63. icroscopic and otoscopic lexamination confirms the presence of ear mites Therapeutic cleaning and medications administered Symptoms to be Concerned About Painful or irritated ear canals can be difficult to medicate If the medication is not applied correctly it cannot work Shaking the head digging at the ears with the feet rubbing the ears on the ground and furniture are signs of perpetuating disease and need further attention Diagnostic Plans 043 EAR SWAB 1 00 18 00 The ear material can be removed on a swab This is then applied to a microscope slide and stained In addition debris from the ear is mixed with mineral oil to loosen and disperse mites from the material Microscopic examination will reveal any organisms or disease Therapeutic Plans 5089 Tresaderm 15 ml 1 00 17 25 Tresaderm is effective at killing ear mites and is also anti inflammatory as well as anti fungal Use four drops in each ear daily for 10 days Skip 10 days then repeat for an additional ten days Example of the Treatment Plan Instruction headers are in bold text To add an instruction header to the list 1 From the Lists menu choose Instruction Headers 2 Choose New on the Instruction Header List The Instruction Header Setup dialog box appears 3 In the Description box type the instruction header as you want it to appear on the Treatment Plan 4 Choose OK To change the order instruction headers appear in the Treatment Plan 1 Choose Order on the I
64. ies Canine Breed Retriever Golden Eau Claire WI 54703 Weight 26 pounds 715 555 7219 Birthday 7 3 99 Exam Date 4 19 00 Sex Neutered Staff John M James Technician Laura M Cox Ear Mites Diagnosis Ear mites are tiny white parasites infecting the ear canals of dogs and cats They are highly contagious frequently infesting whole litters of puppies and kittens Severe ear infections cause injury to the ear canal A dark crusty material is present in the infested ear canals Head shaking and ear scratching are common signs Microscopic and otoscopic examination confirms the presence of ear mites Home Care Ear mites are contagious and all contact pets need to be treated Ear mites are not confined to the ears and medications that are used for fleas should be sprayed on the bedding materials to prevent re infestation Keep the ears dry no swimming use a drying solution if the ears become wet or after bathing A drying ear cleanser that creates an acid pH in the ear canal that is antibacterial and antifungal is recommended Use this for maintenance twice weekly and after the ears become wet Additional Information Ear mites live and breedin the ear canals but are ahr to the ear canals Ear mites usually cannot be controlled by ear medicine alone and topical flea shampoo is recommended every week during this treatment to kill surface mites as well Medications 2318 Ear Flushing 1 00 15 00 Large amounts of discharge wax and debr
65. in certain rooms or with specific staff members when they are checked in Then when you log into Patient Advisor using the staff and room only those patients that are checked into that room or with that staff member will appear on that workstation Use the check in time to reflect the patient s appointment time if you check in several patients at once for instance at 7 30 each morning For more information on checking in patients please refer to the Cornerstone Reference Manual To open the Patient Check In from Patient Advisor From the Activities menu choose Check In Out Choose the Check In Out toolbar button from the taskbar Choose Check In from the Census List From the Lists menu choose Census List or press F3 The client and patient alerts appear when you access a patient using the Patient File or the Physical Exam ELI For more information on client and patient alerts please refer to the Cornerstone Reference Manual A guide to using Patient Advisor Introduction to the Physical Exam e 49 Introduction to the Patient File Items display in the Patient File as the result of using the Physical Exam and Exam Wizard Any information collected and prepared through the Physical Exam is held in the Patient File From the Patient File dialog box you can e View the patient s medical history e View departing instructions invoice transactions and images e Diagnose through the Physical Exam Wizard e Update the patient s
66. ing the Patient Advisor module requires that the start up data is uploaded To import species specific data into the Patient Advisor module link the species name you use Cancel with the standard species names below If you do not treat this species select lt None gt If a species name is left as lt None gt no data will be uploaded for that species r Species link Avian favin yi Bovine Bovine w Canine Canine yi Caprine Capin w Equine Equine O Feline fine Ferret fret wy Reptile Amphibian Reptile Amphibian z Gerbil Gerbil w Guinea Pig GuneaFig x Hamster Hamster O Mouse Mouse Ovine Ovne ss Porcine Porcine Rabbit Rabbt 1 The species the Upload can identify appear in the fields 2 Using the drop down list box choose your species name from the list If you do not use a species choose None Warning Verify the species information you have chosen You will not be able to redo this process and if your species are not identified here the start up data related to that species will not be loaded 3 Choose Process to link the species information The start up data is now installed into your database Related topics See the section Linked vs Non linked Invoice Item IDs on page 18 A guide to using Patient Advisor Before you can use Patient Advisor 7 Logging into Patient Advisor As in all Cornerstone programs when you start the program the
67. is accompany most ear disease This material build up prevents medications rom reaching the problem areas and may inactivate antibiotic medications Therefore a flushing and cleaning of the ear nal prior to therapy is recommended This procedure may require sedation if the ear canal is painful 2613 N Tresaderm Solution 15 ml 1 00 17 00 Tresaderm is effective at killing ear mites and is also anti inflammatory as well as antifungal Use four drops in each ear daily for 10 days Skip 10 days then repeat for an additional ten BS Rechec Mites are difficult to control Their eggs will hatch in ten days and the new mites will be killed the next application of the medication Periodic rechecks are needed to make sure that the mites are effectively controlied Ear flushing may also be necessary at that time Symptoms t be Concerned About Painful or irritated ear canals can be difficult to medicate If the medication is not applied correctly it cannot work If the ear is too painful for you to medicate then please call the office so that alternative medications can be administered Shaking the head digging at the ears with the feet rubbing the ears on the ground or furniture are signs of perpetuating disease and need further attention When you link your invoice The Treatment Plan uses Both general treatment items to the diagnostic Instruction Headers to information and information codes prices are included organize information The specific to a p
68. ither all or a range and the number of records read It also displays the number of pages in the report and the current page being viewed ELI Please refer to the chapter ANALYZING YOUR PRACTICE USING REPORTS in the Cornerstone Reference Manual for detailed instructions on printing previewing and saving reports A guide to using Patient Advisor Analyzing Patient Advisor Using Reports e 85 Generating Diagnostic Reminders Reminders are an important tool for your practice With the ability to send reminders based on the patient s diagnosis you can expand your reminder system to include updates on new procedures or medications for diseases or chronic conditions Generating reminders pulls the reminder data from the patient files based on the diagnosis and holds that information in another file so you can use it to print your reminder postcards or letters ELI For more information on Reminders refer to the chapter USING REMINDERS in the Cornerstone Reference Manual Before you begin understanding flagged diagnoses Flagged diagnostic codes are those that display the tickler icon in the Physical Exam To generate diagnostic reminders 1 From the Reports menu choose Reminders by Diagnosis 2 Select the Sort order 3 Select to Send To Flagged Diagnoses or All Diagnoses All Diagnoses sends reminders based on all the diagnoses that were assessed in the Physical Exam Flagged Diagnoses sends reminders based on the diagnoses that wer
69. ke you can choose which systems Cancel a Si should print and change the order now Behavior Blood Disorders Breed Predispositions Cardiovascular Chemical and Physical Disorders Gastrointestinal Hematology Immunology non derm Infectious Diseases Related topics Introduction to the Physical Exam Page 45 44 e Customizing Patient Advisor A guide to using Patient Advisor Introduction to the Physical Exam Overview The Patient File and the Physical Exam work together to make entering and changing information easy Use the minimized icons of the Patient File to know which patients are checked into the practice and are waiting to be seen Use the Patient File to view the patient s medical history and add pertinent information during the exam From the Patient File you can continue with a diagnosis through the Physical Exam and the Exam Wizard The wizard creates an outline that will provide a consistent standard of care and creates the personalized Treatment Plan and Pet Health Report Card for the patient At any time during a diagnosis through the Physical Exam you can choose to go directly to the end For instance if it s a procedure you perform on a regular basis and you know the treatment information is correct and does not need any editing you can choose Finish to return to the Physical Exam dialog box and save post or print the Pet Health Report Card and Treatment Plan On the following pages you will find a represe
70. l subsystems observations and diagnostic codes except the generic items must be deleted first To delete a system subsystem observation or diagnostic code 1 Select the item to delete 2 Choose Delete A message appears asking you to confirm your decision 3 Choose OK A guide to using Patient Advisor Customizing Patient Advisor e 33 Setting up Treatment Templates Adding information places Treatment templates display under instruction headers in Patient Advisor Setup and are used by Patient Advisor during the Physical Exam Treatment templates include e General information about the diagnosis e Invoice items to dispense or services to perform e Information specific to included invoice items or services Treatment templates designated by the paper icon in the Patient Advisor Setup window print below the instruction header on the Treatment Plan For each instruction heading you can include text about the diagnosis This text might include home care instructions medicinal information or special care instructions Before you begin Before you begin adding or updating treatment information or invoice items within a diagnostic code you must set up the instruction headers and diagnostic codes See Setting up the Instruction Header Lists on page 23 and Setting up the Diagnostic Codes Lists on page 25 To add general information on a new Treatment Template 1 Onthe Lists menu choose Patient Advisor Setup Select the
71. le for patient liability with respect to the use of any information contained within Patient Advisor Your use of the Patient Advisor software is subject to the express terms and conditions of the written license agreement by and between VetConnect Systems Inc and you Before you begin e Install the Upload program to utilize the preprogrammed information Refer to page 7 for information on installing the Upload program e Print the Instruction Templates Report to see what is currently set up in the Patient Advisor and what you need to change for your practice Because this report is so large it can take several hours to print We recommend that you print the report for one system subsystem or diagnosis A guide to using Patient Advisor Customizing Patient Advisor e 17 Linked vs Non linked Invoice Item IDs The preprogrammed information installed by Patient Advisor includes recommended treatment items and instructions contained in the various treatment templates To use the treatment items you will need to assign the appropriate invoice item ID to each treatment item to reflect your practice s invoice item structure It is not necessary to set up all the recommended treatment items prior to using Patient Advisor Why should link my invoice item IDs to the treatment items There are some advantages to linking your invoice item IDs e Patient Advisor will list your practice s prices for services on the Treatment Plan and will als
72. log box item s prices will print on the Treatment Plan If Print Prices is not selected the invoice items prices will not appear on the Treatment Plan If Print Totals is selected a total for all of the invoice items will be included 5 Choose Save Modifying a Saved Open Exam When an open exam is chosen the Physical Exam dialog box contains the previous exam s information You can modify or add to this exam with the necessary treatments or instructions To modify the exam 1 Select an open exam from the Patient Exam List 2 Proceed through the Exam Wizard as usual You can make changes as necessary 3 Choose Finish to complete the exam 4 Choose Save to leave the exam open Or Choose Post to close the exam Or Choose Print to print the Pet Health Report Card and the Treatment Plan 80 e Finishing the Physical Exam A guide to using Patient Advisor Performing a Recheck You can perform a recheck exam on a closed or open exam When you choose recheck the Physical Exam dialog box contains the previous exam s observation information only You can add to this exam with necessary follow up care instructions and treatments To perform a recheck 1 Select an open or closed exam from the Patient Exam List and choose Recheck Proceed through the Exam Wizard as usual You can make changes as necessary Choose Finish to complete the exam Choose Save to leave the exam open Or Choose Post to close the exam Or Choose P
73. m the appropriate drop down lists if applicable 6 Select the Enabled check box to use this diagnostic code during a physical exam Note A diagnostic code is disabled and cannot be used for a patient exam until the practice has approved it by selecting the Enabled check box 7 Select the Linked check box to associate this diagnostic code with invoice items used by your practice A guide to using Patient Advisor Customizing Patient Advisor e 25 Note Ifthe Linked check box is selected the invoice items entered in Patient Advisor Setup will be transferred to the Patient Visit List when this diagnostic code is used 8 Select the Send Reminders check box to flag the diagnosis in the physical exam You will be able to send reminders to patients with this diagnostic code in their Patient File 9 Ifyou chose to enable this diagnostic code but did not link it you will want to utilize the Exam Message field The content of this field prints on Patient Advisor reports You can put an estimate range in this field Note Only one exam message can print on the report If you select two or more diagnostic codes a pop up box will display any applicable exam messages Choose the most appropriate message to print 10 Choose OK Diagnostic Code Setup x M Diagnostic code information Diagnostic code 06 VPI description BSP Cancel Hospital desc BSP Default status Tentative Status facive J mM Patient Advisor settings
74. marked as linked Modify the information as necessary Choose OK See Linked vs Non linked Invoice Item IDs on page 18 A guide to using Patient Advisor Customizing Patient Advisor e 41 To delete general information or an invoice item 1 Click the information or invoice item to delete 2 Choose Delete Related Topics Updating Systems Subsystems Observations and Diagnostic Codes Page 32 Setting up System Templates Page 43 Setting up Treatment Templates Page 34 Deleting Systems Subsystems Observations and Diagnostic Codes Page 33 Introduction to the Physical Exam Page 45 42 e Customizing Patient Advisor A guide to using Patient Advisor Setting up System Templates The text of the selected system is green Patient Advisor uses System Templates to determine how to structure the Physical Exam In Cornerstone Foundation the Species option found on the Lists menu allows you to link a species to a system template This system template will be used in Patient Advisor when that species is examined For more information see Setting up Species and Breeds in the Cornerstone Reference Manual Mark the system template to use for the majority of your physical exams as the default This template includes e The systems to appear in the Physical Exam dialog box e The systems to print on the Pet Health Report Card and the order they appear e The default observation status normal abnormal or did not examine that appea
75. mation linked to the diagnosis Change or add any information as necessary At any point you may choose Finish to immediately create the Treatment Plan without reviewing the remaining instruction headers Choose Next to continue through the screens The last screen will be a summary of the abnormal systems and the diagnoses Choose Finish 8 You will return to the Instructions tab of the Physical Exam Modifications to this exam can be done by double clicking on the part of the exam that you want to change You can choose to print post or save the Physical Exam Post will close the exam Changes cannot be made to a posted exam Save allows you to reopen this exam at a later time to change and edit the information as necessary You can also do a recheck on a saved or posted exam amp Exam Wizard Treatment x Diagnosis Ear Mites pa Diagnosis i 6 x Ear mites are tiny white parasites infecting the ear canals of dogs and cats They are highly contagious frequently infesting whole litters of puppies and kittens Severe ear infections cause injury to the ear canal A dark crusty material is present in the infested ear canals Head shaking and ear scratching are common signs Microscopic and otoscopic examination confirms the presence of ear mites Add Insert Delete Page 5 of 12 Cancel lt lt Back new gt gt Finish Physical Exam Jack and Cathy Myan with Keller MEE on E kom inde n
76. medical history e Update comments patient weight and diagnoses e Prescribe medications and print prescription labels e Check in a patient e Update patient images To open the Patient File e Double click the patient s minimized icon in Patient Advisor The patient s file appears automatically OR Click Patient File from the Activities menu Select the patient and press TAB OR Choose the Patient File toolbar button from the taskbar Select the patient and press TAB Viewing and adding to the Patient File The Patient File will show the medical history of the patient The dialog box displays the patient information such as age weight sex and breed and owner information such as name balance credit code and last payment information The Patient File displays medical history such as patient comments prescriptions weight history invoice items diagnoses departing instructions physical exams check in declined history and patient images You can customize the information that you want to view in the patient file ELI For more information about customizing the information to be viewed in the Patient File and adding information to the Patient File refer to the Cornerstone Reference Manual 50 e Introduction to the Physical Exam A guide to using Patient Advisor Introduction to the Physical Exam The Physical Exam is the main feature of Patient Advisor The Physical Exam will e Walk you through the diagnosis e Record
77. nd the Treatment Plan Adding a new observation to the Patient Advisor List for use with other systems 1 Double click the observation or right click the observation and choose Update The Exam Wizard will display Click in the Observation box and press F2 or choose the Search button The Observations List will display Choose New The Observation Setup dialog box appears Select the system observation type and species to link to this observation Select the Default check box to use this observation as the default for this system If you select this item as default this observation becomes the default 58 e Using the Physical Exam A guide to using Patient Advisor for this system type and species and Patient Advisor clears the default check box of any previous default observations Type the observation text Choose OK The new observation appears in the Observation box oOo N O If you want to use this observation on this exam choose Add The observation text will move the lower box 10 Choose OK to save your changes and return to the Exam Wizard System dialog box 11 Choose Finish to return to the Physical Exam Choose Next to continue with the diagnosis amp Timesaver If you modify an observation you automatically proceed through the wizard Choose Finish to return to the Physical Exam Physical Exam Abby Gail with Starbuck Patient information Exam information ID 556 Sta
78. ng ID filters you can often press F2 to select the ID to use Diagnosis Count Report The Diagnosis Count Report shows a count of the number of times a diagnosis has been used Sort Order Diagnostic Code and Diagnostic Description Filters Diagnostic Code Description and Date Range Report Details Each instance of a diagnosis being given to a patient will be counted and included on this report The report shows the diagnostic ID description and the number of times diagnosed Use this report to locate target markets Diagnostic Code Report The Diagnostic Code Report provides a list of your existing diagnostic codes Sort Order Diagnostic Code and Diagnostic Description Filters System Subsystem Default Status Status VPI Code Diagnostic Code and Diagnostic Description Report Details The report shows the Diagnostic Code Description Default Status VPI Code and Status active or inactive Instruction Templates Report The Instruction Templates Report lists all the treatments and instructions assigned to a particular diagnostic code You can select what you want to include in this report Sort Order System Description Filters Diagnostic Description Instruction Description System and Subsystem Report Details The report shows the system subsystem diagnostic code instructions linked to the diagnostic code Use this report to review the start up data included with Patient Advisor Caution This report can be ext
79. ng Patient Advisor e 21 The information in Patient Advisor Setup includes 4 Systems Systems designated by the file folder icon are the highest or most general level of diagnoses Patient Advisor comes preprogrammed with the major body systems examined during a patient exam See page 28 Z su bsystems Subsystems designated by the icon of a file folder with two tabs further classify system disorders Several subsystems are included with the Patient Advisor See page 28 eS Observations Observations designated by a book icon are the symptoms you look for in a normal or abnormal situation Each system includes Normal Did Not Examine and Abnormal observations Observations print on the Pet Health Report Card See page 30 e Species specific Observations Species specific Observations designated by the dog icon within an observation type contain observation text for a specific species See page 30 Observation text Observation text indicated by the single paper icon within an observation type are specific abnormal or normal conditions See page 30 Diagnostic Codes Each subsystem contains Diagnostic Codes designated by the microscope icon A diagnostic code can also be linked to an undeclared subsystem Each diagnostic code has an ID a VPI description hospital description default status tentative final or ruled out status active or inactive enabled option linked option and send reminders option You can associate sp
80. nnie noen ra e E ke ban RE E EEE ena pe ee 17 Linked vs Non linked Invoice Item IDS seessseseesseseesessesreseeressteresseserssseesessreresseseessseese 18 Why should I link my invoice item IDs to the treatment it MS verreseeerereeoe 18 To link invoice items through the Patient Advisor Setup eecceseeceeeecneeeeenereres 19 To link invoice items through the Physical Exam cceeceeecseeeceteeeeeeceeeeeeneeeees 19 Updating matching codes feature eccecceseeseceseceeceseceecseeeneeeseeeeeeereeereneeeeeaees 20 Introduction to the Information included in Patient Advisor Setup 0irerrreeerrerrerreeroanooonnon 21 A guide to using Patient Advisor Contents ei Setting up the Instruction Header LISL 0 0i02eiee vite tete aeteae tate teat aaaeaaaoasassanssanesasesosssosanosanonanonn 23 To add an instruction header to the list 00 ce ceeeeeeeccsseeeeeeceseeceeeeceaeeeeeseeaeeeeeaeens 23 To change the order instruction headers appear in the Treatment Plan 23 Setting up Diagnostic Codes ei ces aycciec eis eh Go a RRR eda Ba ek SA es 25 To open the Diagnostic Codes List ccccesccsseesseesseeseeesceeeceeenecnseenseenaecaeesseenaeenaes 25 To open the Patient Advisor Setup Window cccccsscssseesseeseeeseeeeeeseceeeceeeneenaeenaes 25 To add a Diagnostic Code eeeeccecscessesescessceecesecsecnecseecaeeeaeeeaeeeneeeeeeeseneeneenseenaes 25 Setting up Systems and Subsystems
81. nstruction Header List The Instruction Header Order Setup dialog box appears 2 Click the instruction header to move and click the up or down arrow to change the order of the highlighted instruction 3 Repeat step 2 to change the order of another instruction header or choose OK A guide to using Patient Advisor Customizing Patient Advisor e 23 Instruction Header List xj information Description Additional Information Update Additional Information me Diagnosis Delete Diagnostic Plans Diet Close Home Care Medications Order Recheck Symptoms to be Concerned About Therapeutic Plans Instruction Header Setup x Description J Ok Close Add a new Instruction Header by choosing New Type the Instruction Header description and choose OK l Instruction Header Order Setup x OK Additional Information Home Care Medications Recheck Symptoms to be Concerned About Diagnostic Plans Therapeutic Plans Change the order the instructions print on the Treatment Plan and appear in the Patient Advisor Setup by using the up and down arrows Results e When you print Treatment Plans the instruction headers appear above each section of information e The instruction headers appear under each diagnostic code in the Patient Advisor Setup Related topics Printing Treatment Plans Page 81 Updating Systems Subsystems Observations and Diagnostic Codes Page 32 24 e Customizing Patient
82. nt the Treatment Plan 3 On the Patient File tab Patient Advisor Defaults x Pet Health Report Card Treatment Plan Patient File Ok Fot Close Maximum number of patient files to open E a e Enter the maximum number of patient files you want to appear as minimized icons in the Patient Advisor window There is a minimized icon for each patient checked into the practice 4 Choose OK A guide to using Patient Advisor Two reports your clients will love e 15 16 e Two reports your clients will love A guide to using Patient Advisor Customizing Patient Advisor Introduction Patient Advisor includes preprogrammed information however you should customize this information to reflect how you practice veterinary medicine in your practice Patient Advisor uses the standard body systems and subsystems and associates observations diagnoses and instructions to these standards Although you set up customized medical information you can still modify specific information as you conduct the physical exam All of this medical information appears in the Patient Advisor Setup the heart of the Patient Advisor Customize the medical information through the Lists menu Important Before you begin using Patient Advisor read this manual and the preprogrammed information included in the Patient Advisor software Use the instructions in this manual to add or change the information to meet your practice s specific needs We are not responsib
83. ntation of a typical routine using Patient Advisor Before you begin e One observation text for each status under each system must be marked as a default in order for observation text to appear in the Physical Exam e One treatment template for each instruction header under each diagnosis must be marked as a default in order for the treatment template to appear in the Physical Exam A guide to using Patient Advisor Introduction to the Physical Exam e 45 azi ES Lists Reports Window Help 1 Click the Patient File icon to view a B2 ESETGISLOABA ov patient s medical history or click on the desired checked in patient Checked in patients records are minimized at the bottom of the screen Click on the square button to restore the record to full size G keller Jac ENE ES O Starbuc 2 From the Patient File you can view the history of the patient Choose CE na Physical to continue through the Patient information Physical Exam 0 m Kek JES Maed 2710700 kon 14 5 pounds 2710700 MI Complaning of excessive scratching 2 10 00 10 Reason for Visit Yearly Exam 177700 il 1 25 00 Tablet of Rimadyl 50 mg tablets 3576 for 5 00 by LAC 10 2099 A 1 1 00 Rabies Canine 3 Year Vaccine 3223 for 15 00 by LAC 10 20393 A 1 1 00 Parvovirus First Vac 3220 for 10 00 by LAC 10 2039 A 1 1 00 Bordetella First Vac 3203 for 10 00 by LAC 10 20 393 A 1 1 00 Corona First Vac 3206 for 10 00
84. o include a total amount e Patient Advisor will automatically transfer your charges to the Patient Visit List From the Patient Visit List charges can be transferred to an invoice in Cornerstone You may choose to use Patient Advisor for a while before linking your invoice item IDs It will allow you to become familiar with the software and then you can decide which items should be included in specific systems 18 e Customizing Patient Advisor A guide to using Patient Advisor To link invoice items through the Patient Advisor Setup From the Lists menu select Patient Advisor Setup Use the Patient Advisor Setup to view the existing information You can add your IDs to the items as you discover unidentified items Note A diagnosis must be marked as linked before any linked item IDs will display price information and print on the Treatment Plan Use F2 to locate your item s ID If an item does not exist it can be created in Cornerstone Foundation or another item can be chosen from your invoice item list You can also delete any of the invoice items or instructions that you do not want to appear in the recommended treatments Deselect the green check mark of any item you do not want to print on the Treatment Plan To link invoice items through the Physical Exam You can also add IDs during a Physical Exam From the Activities menu select Physical Exam You will be prompted to insert your ID if you try to leave the dialog box without ente
85. oose the left arrow Choose Next to continue through the wizard To change the order of the instructions to print 1 2 If you need to add an instruction heading for an item not specified to print you can move the item and then add instructions and treatments as necessary Choose the instruction to be moved The item displays in green Use the up and down arrow keys to move the instruction to the order in which you would like it to appear on the Treatment Plan The instructions will print in the order displayed keyi Exam Wizard Treatment List x Diagnosis GENNI Instructions to print Instructions Don T T gt aj Additional Information Mites all over body l 4 si r Page 4 of 13 Cancel lt lt Back new gt gt Finish Note This dialog box will appear for each diagnosis that was entered on the previous dialog box A guide to using Patient Advisor Using the Physical Exam e 65 Results e When you choose Next the wizard proceeds to the Exam Wizard Treatment dialog box where you can view modify and add treatments for each diagnosis for this patient e When you choose Finish the wizard returns to the Physical Exam where you can change save post or print the Pet Health Report Card and Treatment Plan for this patient Related topics Adding Instructions to the Diagnosis Page 67 Adding a Treatment to the Diagnosis Page 69 Modifying Treatment Templates Page 72 Po
86. ou would observe in this situation 6 Choose OK The observation will be inserted underneath the coinciding system and observation type on the Patient Advisor List 30 e Customizing Patient Advisor A guide to using Patient Advisor Observation Setup x System Ears a Observation type Abnormal Cancel Species Undeclared m T Default Observation text Results e The observation status and observation text appears on the Physical Exam dialog box e When an observation is chosen in the Physical Exam the system will first search for a species type specific observation then a type specific observation then species specific observation and finally a general observation Related topics Setting up Diagnostic Codes Page 25 Setting up Treatment Templates Page 34 Updating Systems Subsystems Observations and Diagnostic Codes Page 32 Deleting Systems Subsystems Observations and Diagnostic Codes Page 33 Introduction to the Physical Exam Page 45 A guide to using Patient Advisor Customizing Patient Advisor e 31 Updating Systems Subsystems Observations and Diagnostic Codes Important Before you begin using the Patient Advisor read this manual and the preprogrammed information included in the Patient Advisor software Use these instructions to update the information to meet your practice s specific needs We are not responsible for patient liability with respect to the use of any information contained
87. r and Cornerstone Foundation work together in many ways e As patients are checked into the practice the patient s file appears as a minimized icon in Patient Advisor This allows any staff member to easily access the patient s medical history e The check in feature is also available in Patient Advisor e As you perform services or dispense medicines during the physical exam these items may be added to the Patient Visit List in Foundation e The Patient Census appears in both Cornerstone Foundation and Patient Advisor so you can quickly see who is checked into the practice e Patient Advisor uses species information set up through Foundation e You can add a patient picture to a patient s medical history which you can view in Patient Advisor or Foundation Patient Advisor and Prescription Labels When using Patient Advisor you can prescribe medicine from e The Patient Visit List e The Patient File e The Physical Exam e Prescription Labels on the Activities menu A guide to using Patient Advisor Before you can use Patient Advisor e 5 Getting Started with Patient Advisor a Checklist O Review your species information from the Cornerstone Foundation During the Upload process the program that installs the start up data you must link your species IDs to the ones preset in Patient Advisor Make sure to link all applicable species The upload process is done only once See next page O Immediately after installing Patient Advi
88. rbuck Admit 04 20 00 Staff John M James wi 9 Mos 26 pounds poovos A l Save Retriever Golden Neutered Release 00 00 00 MA Laure M Cox Observations Instructions Systemtemplate Canine a Gastrointestinal There is no history of vomiting or diarrhea and the pet has a normal healthy appetite Normal Feeding a high quality diet appropriate for your pet s life stage is recommended to help maintain optimal health Cardiovascular The heart is strong and healthy Each heart valve sounds normal There are no murmurs Normal abnormal sounds The pulse has a normal rate and strength The pulse has a normal regular thythm Capillary refill rate is rapid indicating good peripheral circulation Respiratory Respiration is normal All the lung fields sound clear and healthy and your pet has a normal Normal breathing rate and depth The trachea windpipe is of normal size and sensitivity for the breed Eyes yes are bright clear and free of discharge Externally i ti Normal are intact and healthy Internally the ocular lens is hea KAL NNA iri natural color and texture Abnormal Skin and Hair Coat Healthy hair coat and skin No scabs scales crusts t Did Not Examine Normal parasites irritation or history of itching A program for p Pri recommended v Print Systems Update Diagnose A guide to using Patient Advisor Using the Physical Exam e 59 Exam Wizard System x E
89. remely long Consider using filters when printing this report 88 e Analyzing Patient Advisor Using Reports A guide to using Patient Advisor Observations Report The Observations Report shows the observation text for all normal and abnormal systems Sort Order System Filters System Report Details This report shows the system status species default and the observation text for each body system Open Physical Exam The Open Physical Exam Report lists all patients with open exams in admission date order Sort Order Date Filters Date Patient ID Patient Name Staff ID and Staff Name Report Details The report shows the date admitted exam ID patient ID patient name client ID client name and staff member Use this report to review the open exams and determine if a recheck exam is necessary or if the exam should be posted Patient Advisor System Setup Report The Patient Advisor System Setup Report provides a list of the system names in alphabetical order by system description and the names of the subsystems in each system Sort Order Description Filters Description Patient Diagnosis Report The Patient Diagnosis Report shows a list of all patients that have received a specific diagnosis Sort Order Diagnostic Code and Diagnostic Description Filters Date Diagnostic Code Diagnostic Description Patient ID Patient Name and Diagnosis Status Report Details This report includes the diagnostic code diagno
90. ring the ID Choose OK to return to the Physical Exam and enter your item ID Note A diagnosis must be marked as linked before any linked item IDs will display price information and print on the Treatment Plan Use F2 to locate your item s ID If an item does not exist it can be created in Cornerstone Foundation or another item can be chosen from your invoice item list You can also delete any of the invoice items or instructions that you do not want to appear in the recommended treatments Deselect the green check mark of any item you do not want to print on the Treatment Plan A guide to using Patient Advisor Customizing Patient Advisor e 19 Treatment Template Setup x Diagnosis Otitis Externa Species Undeclared Medications M Default Otitis Extema HB101 ltem ID Description I HB101 Nolvasan Appb 4 drops twice daily vi Nolvasan should not be used if the ear drum is ruptured Staff ID Ok Save As Close This treatment needs an item ID associated with it Use F2 to locate your invoice item ID Ifyou try to leave the Exam Wizard Treatment dialog box without updating the item IDs this warning will Exam Wizard Treatment display Choose OK to return to the dialog and add the ae item IDs Be sure to scroll down through the dialog gt All linked treatments must have items associated with them box if necessary to change additional item IDs This message could appear more t
91. rint to print the Pet Health Report Card and or the Treatment Plan Printing the Pet Health Report Card and the Treatment Plan Before you begin Complete a physical exam Open a saved or recheck exam To print the Pet Health Report Card and the Treatment Plan 5 On the Physical Exam choose Print You can choose to print the Pet Health Report Card and or the Treatment Plan The header and footer information appears automatically as set up in Data Defaults Change the information as necessary If Print Item IDs is selected the invoice item IDs used by your practice will print on the Treatment Plan If Print Prices is selected the individual invoice item s prices will print on the Treatment Plan If Print Prices is not selected the invoice items prices will not appear on the Treatment Plan If Print Totals is selected a total for all of the invoice items will be included Choose Print Note Ifyou choose Print Preview only the current diagnosis displays A guide to using Patient Advisor Finishing the Physical Exam e 81 Patient Visit List The Patient Visit List is available in Patient Advisor Information from the other features of Cornerstone including Appointment Scheduler and Prescription Labels is stored here Information from Patient Advisor will display next to the thermometer icon located in the left margin The information in the Patient Visit List can then be applied to the invoice The Patient Visit List
92. rs on the Physical Exam dialog box This allows you to customize the Physical Exam on the systems you examine most for each species To add a System Template 1 From the Lists menu choose System Templates 2 Choose New The System Template Setup dialog box appears 3 In the Description box type a description for this system template 4 Select the Default check box if you want to use this template for the majority of your physical exams You can only have one default template per species If another template is marked as default selecting the default check box here will deselect the other template This template will display by default in a Physical Exam but you can choose a different template when using the Physical Exam 5 Select the systems to include in this exam template To include a system click the box to the left of the system to make the check mark appear Click the check mark to remove the system from the exam template 6 Select a default observation status for this system Normal Abnormal or Did Not Examine Order the systems as you want them to appear in the Physical Exam and on the Pet Health Report Card To move a system click the system and then click the arrow key to move the system up or down in the sequence 8 Choose OK A guide to using Patient Advisor Customizing Patient Advisor e 43 System Template Setup x Description avian T Default ok The following systems have been selected If you d li
93. s Page 72 Posting the Exam Page 78 Saving the Exam Page 80 A guide to using Patient Advisor Using the Physical Exam 63 Adding Exam Notes to the Physical Exam Use the exam note to save comments about the exam Notes are saved in the medical file with the exam The note will not print on the exam To add exam notes 1 From the Physical Exam dialog box choose Note 2 Type the note and choose OK The exam note can be modified on an open or new exam and viewed on a closed exam Exam Note EI OK Close g 64 e Using the Physical Exam A guide to using Patient Advisor Selecting Instructions to Print in the Exam Wizard In the Exam Wizard a treatment template appears for each diagnostic code that was entered on the previous dialog box Review the information that you want to print on the Treatment Plan The instruction headings in the Instructions to Print box will print by default on the Treatment Plan To determine the instruction to print on the Treatment Plan 1 You can also double click in the instruction to move it to the Instructions 3 to Print box 4 The instruction header and the title of the default template to print appear in the Instructions to Print box If you want additional instructions to print select the instruction and choose the right arrow to move the instruction to the Instructions to Print box To remove an instruction from the Instructions to Print box select the instruction and ch
94. servation status 1 Right click on the observation and choose Normal Abnormal or Did not Examine 2 The status of the item and the text changes according to default text that is set up for the status If there is no default text for the status the text area will be left blank To change the observation text 1 Click on the lookup icon and a dialog box will display with the observations 2 Click the desired observation If you change the observation status the text will change according to the default text that is set up for that status Physical Exam Abby Gail with Starbuck 5 xf r Patient information Starbuck Admit Baz20700 g Staff John M James ID 556 9 Mos Retriever Golden Exam information s Save 26 d Ni gen Release Joovoozo0 El Tech Laura M Cox yi Cancel Observations mstructians l System template Canine Y Dx Rx Gastrointestinal Normal Cardiovascular Skin and Hair Coat Normal There is no history of vomiting or diarrhea and the pet has a normal healthy appetite Print Feeding a high quality diet appropriate for your pet s life stage is recommended to help maintain optimal health Note The heart is strong and healthy Each heart valve sounds normal There are no murmurs abnormal sounds The pulse has a normal rate and strength The pulse has a normal regular rhythm Capillary refill rate is rapid indicating good peripheral circul
95. sor and logging into Patient Advisor the first time the Upload program is initiated This program installs the Patient Advisor information The program must be completed before you can use Patient Advisor See below O Review the start up data thoroughly before starting to use Patient Advisor The information may need to be customized to meet your practice s needs or procedures O Use the Patient Advisor List to link your invoice item IDs to the items that are resident in the start up data Having as many linked as possible before you get started will prevent delays during a physical exam Carefully review the amount dispensed to make sure it meets your approval Installing Patient Advisor To install Patient Advisor insert the CD into the CD ROM drive choose Run from the Start menu on the taskbar type d setup where d represents your CD ROM drive and then choose OK Follow the instructions as they appear The First Time you Start Patient Advisor The Upload program contains the information included with Patient Advisor The information needs to be converted to match your database Before you begin e The program s database update must have been completed You should have been automatically prompted to do this when you started the program e The upload must be performed on the server 6 e Before you can use Patient Advisor A guide to using Patient Advisor To run the Upload program F Patient Advisor Upload x Before proceed
96. stic description patient ID and name the date diagnosed and the status of the diagnosis The total number of patients with the diagnosis is shown The report will not show duplicate diagnoses For instance if a patient has been diagnosed with congestive heart failure more than once it is listed only once on the report If you choose to export this report additional information such as client ID name and address is included in the file Use the Patient Diagnosis Report to locate opportunities for target mailings A guide to using Patient Advisor Analyzing Patient Advisor Using Reports e 89 Patient Diagnosis Status Report The Patient Diagnosis Status Report shows the patients diagnoses and their status Sort Order Diagnostic Code and Diagnostic Description Filters Diagnostic Code Diagnostic Description Date Patient ID Patient Name Patient Status Report Details This report shows the diagnostic code and diagnostic description patient ID and name diagnosis status and the patient status Each instance of a diagnosis being recorded will be included on the report If the information is saved to a file the client ID name and address will be included in the file Diagnosis by Staff Report The Diagnosis by Staff Report shows the number of times a staff member has used a diagnosis Sort Order Staff ID and Staff Name Filters Staff ID Staff Last Name Date Diagnostic Code and Description and Diagnosis Status Report Details
97. sting the Exam Page 78 Saving the Exam Page 80 66 e Using the Physical Exam A guide to using Patient Advisor Adding an Instruction to the Diagnosis in the Exam Wizard For each diagnosis instruction a detailed treatment dialog box appears You can add or change information Opening the Exam Wizard Treatment dialog box Choose DX RX from the Physical Exam and proceed through the wizard to the Instruction tab of the Physical Exam which displays the Treatment Plan Right click an instruction header procedure or text entry and choose Update To add an instruction Adding an instruction treatment will place it as the last item in the dialog box 1 2 Select Add You can choose to add instruction text or a treatment an invoice item Select instruction and choose OK Type the instruction text in the box for this diagnosis Choose Finish to return to the Treatment Plan or choose Next to continue through the Exam Wizard To insert an instruction Inserting an instruction treatment will place the new item above the item where the cursor is currently located 1 2 Select Insert You can choose to add instruction text or a treatment an invoice item Select instruction and choose OK Type the instruction text in the box for this diagnosis Choose Finish to return to the Treatment Plan or choose Next to continue through the Exam Wizard A guide to using Patient Advisor Using the Physical Exam e 67 Lo Exam Wizard
98. system subsystem and click on the appropriate diagnosis Under the applicable diagnostic code click the instruction heading designated by the multiple papers icon that applies to this instruction and choose New The Treatment Templates Setup dialog box appears 2 Type a detailed description of this treatment template This description appears in the drop down list in the Exam Wizard Treatments dialog box but does not print on client reports 3 Select a Species if this instruction only applies to a specific species 4 Select the Default check box to use this treatment template as the default within this header or group of species specific templates for this diagnosis At least one treatment template must be a default or the system will not automatically appear on the Physical Exam A treatment template can still be selected from the drop down list in the Exam Wizard Treatments dialog box Note Ifyou select the Default check box this treatment template becomes the default and Patient Advisor clears the Default check box of the previous default template for each species 5 Click the Add button The Treatment Type dialog box appears it at the bottom of the template 34 e Customizing Patient Advisor A guide to using Patient Advisor Treatment Type EI Do you wish to enter afn Invoice item Cancel Specific item information Sample Treatment Type dialog box 6 Specify General Information to add text abou
99. t Line by Line cc ccceccceescesscessceseceseceseceeecaeeseecaeecaeeeneesaeeneeeerenrees 58 To add observation text line by linE 2 0 cc eeceecceecceseeeseceseceecaeeeaeeeeeeseeeaeeeseeneeeeeeees 58 Adding a new observation to the Patient Advisor List for use with other systems 58 Deleting observation text ic cc 2 cececccckceecenseeseecee ven en ea fe es anven Dee R a i i 60 Diagnosing with the Exam Wizard ccccesccesceeseceecesecseecseceeecaeecseecaeeeeeseeeeeeeeseeeeeeeeeenaees 61 Adding a diagnosis in the Exam Wizard ccecccscseseesseeeeeesceeeeeeeeeeeeeeeeeeeeeneenaees 61 Updating a diagnosis ccsscs vacdeiaie ala Gaui de koka oak pik oa die Lase dane w te pese ound 62 Adding Exam Notes to the Physical Exam c cccccesccesccsseseecseeeeeseeceeeseeeeeeeeeeseeeereneeeeenaees 64 Todd exam notesie iiyn Hic nse kaa ande ran e pie teen ence 64 Selecting Instructions to Print in the Exam Wizard 0 0 ceeceseeccsseceeeeeceeeeeceecereeeaeeeeeaeeaees 65 To determine the instruction to print on the Treatment Plano te eeeeeeeeeneeees 65 To change the order of the instructions to print cccceccesceeseceseceeeeeeeeneeeeeeseeeerees 65 Adding an Instruction to the Diagnosis in the Exam Wizard ceseeesceeeeceeeeeeeceeeeeneees 67 Opening the Exam Wizard Treatment dialog DOX 0 cecceesceeseeeseeseeeeeeneeeeeeeeees 67 To add an instructiOn sss cc cc 2ccsete denise von koko hee on e a sieeve P
100. t this diagnosis and choose OK A text box appears in the Treatment Template Setup dialog box Begin typing when the blinking cursor appears in the box 8 The check mark must appear beside information in order for it to print on the Treatment Plan Type the information in the box 9 Repeat steps 5 8 to add additional information Or Choose OK Treatment Template Setup Ea Diagnosis Ear Mites Species Undeclared Diagnosis E ar mites vi Ear mites are tiny white parasites infecting the ear canals of dogs and cats They are highly contagious frequently infesting whole litters of puppies and kittens Severe ear infections cause injury to the ear canal 4 dark crusty material is present in the infested ear canals Head shaking and ear scratching are common signs Microscopic and otoscopic examination confirms the presence of ear mites M Default Insert Delete OK Save As Cancel Adding information will place a text box in the dialog box Use this feature to communicate information to the client that is important to their pet s health such as home care instructions symptoms to watch for drug interactions or bandage care A guide to using Patient Advisor Customizing Patient Advisor e 35 To add an invoice item to a new Treatment Template You can add invoice items to dispense or services to perform on a patient to a Treatment Template The invoice items or services also called treatments are
101. tems or specific item information 1 Click the instruction or treatment located below where you want to insert a new instruction and then click the Insert button The Treatment Type dialog box appears Select the type of information to insert and choose OK 3 Complete the information in the box or row that appears Treatment status buttons All invoice items are transferred to the Patient Visit List The treatment status button the plus sign next to the treatment item is used to indicate the status of the item for this patient The plus sign is the default and can be modified during the exam Click on the button to change it to a different status The ES indicates the item was recommended to the client The Fa indicates the item s recommendation was accepted by the client Note Don t confuse this check mark with the check mark in the left margin that determines if the line prints on the Treatment Plan The BI indicates the item was performed on the patient and should be included on the invoice The x indicates the item or service was declined by the client The Bi indicates the item or service was declined by the client and you want it to appear in the patient s history A guide to using Patient Advisor Customizing Patient Advisor e 39 Related topics Updating Treatment Templates Page 41 Updating Systems Subsystems Observations and Diagnostic Codes Page 32 Deleting Systems Subsystems Observations and Diagnos
102. the physical exam is a step by step tool to help you through a diagnosis The Pet Health Report Card prints with all the system observation information Ruled out A diagnosis that was suspected but then ruled out as valid Subsystems Detailed system information that further breaks down the patient diagnosis System Templates Used to set up your choices of systems and subsystems to appear on the physical exam document Ifa particular species needs specific systems listed you would define them here Systems Include the basic organized groupings of related structures e g circulatory These systems are not species specific Tentative A diagnosis that is subject to change when more information is gathered Treatment Each diagnosis can have an invoice item associated with it The invoice item is a treatment 92 e Glossary of Terms A guide to using Patient Advisor Treatment Instructions An instruction associated with an individual diagnosis Each instruction can have a unique body of text that would provide information about ongoing care or plans Treatment Plan The document that includes the diagnostic information and the treatment and instruction information the owner needs to care for his or her pet The Treatment Plan was called Patient Advisor Instructions in earlier versions of Cornerstone Treatment Template The dialog box where the treatments instructions and treatment instructions are combined for a
103. tic Codes Page 33 Introduction to the Physical Exam Page 45 The Patient Visit List Page 81 40 e Customizing Patient Advisor A guide to using Patient Advisor Updating Treatment Templates After saving a treatment template you can Add update or delete general information invoice items or specific information about invoice items Before you begin Print the Instruction Templates Report to see what is currently set up in the Patient Advisor and identify what you need to change Because this report is so large it can take several hours to print We recommend that you print the report for one system subsystem or diagnosis To open the Treatment Template 1 Open the Patient Advisor Setup window On the Lists menu choose Patient Advisor Setup Select the System Subsystem Diagnosis and Instruction Header Click the treatment template to open and choose Update The Treatment Templates Setup dialog box appears To update general information invoice items or information specific to invoice items 1 2 3 4 Click the information or invoice item to change The preprogrammed information will not contain an item ID Press F2 to locate your invoice item that matches the treatment to link your item ID If the invoice item does not exist in your database you can add it through Cornerstone Foundation or choose another item You cannot continue through this screen without linking the item ID unless the diagnosis is not
104. tion 39 Treatment Status Duttonss s se csesdetsctsceyecbieststedtasstauethteg tansbos an a e E asa onie 39 Updating Treatment Templates 2 0 0 0 cc cccceseceeesseeseeeseeseceeceseeeseceseeaecaeceecaeeaeceecseecaeeeneeses 41 To open the Treatment Template 00 ecceccesecssecsceeseeeseeeeceeeceeeeeseeeseceseeseeneeneeaees 41 To update general information invoice items or information specific to invoice TESTIS ke ep ben deyo en bonn nen CR eg kone Cele A bee ete Ron Re e og pen een ten va pote sein 41 To delete general information or an INVOICE item eee eeeeeeteceeeeceeeeceaeeeeeneens 42 Setting up System Templates ccccccccecseessessceescessceeecesecesecaeceaecaeecaeecaeecsecaeecaeseneeeeeeneeeneeees 43 To Add a System Template cccecceecccssecsecsseceeeseeeeceseeeseeeneeeeeeeeesenseenseenseenaeenaes 43 Introduction to the Physical Exam 45 OVERVIEW o eunet eins vie desas td hon degre ig denier bog ene 45 Checking Patients into the Practice L0lileoeereretorerreertoseonaosaosoonoosoonaosoonnosaosooouoososooonoone 49 To open the Patient Check In from Patient Advisor cecceesseeseeeseeeeeeteeeteenseenees 49 PV CTS cst ana pon isiya dok Pi kibo fees eg an pete dyob yi E di debe sane lase a je do ao espas sese 49 Introduction to the Patient File eee eesesecseesecneeeeceseeeeesecseesecneeecsaeceseecsaeeeesaecaeeeeeneeereeaees 50 To open the Patient File sonci nnna dwa es Ave Dee en d
105. tion Templates Report 3 17 88 Instructions Index e 95 Add to diagnosis in Exam Wizard 67 Insert in Exam Wizard 67 Instructions tab 77 Instructions to print on Treatment Plan 65 Introduction to Patient Advisor 5 Invoice items 13 Adding to a treatment template 36 69 Advantages to linking 18 Deleting on a treatment template 42 Inserting on a treatment template 39 Item IDs 18 Link 19 Updating matching codes 20 L Link invoice items Through Patient Advisor Setup 19 Through the Physical Exam 19 Linked invoice item IDs 18 Linked diagnostic code 26 Logging in to Patient Advisor 8 Minimized files benefits of 10 Default number to open 15 Minimized icons in Patient Advisor 9 45 N Non linked invoice item IDs 18 O Observation text 12 22 30 Add line by line 58 Change 56 Deleting 60 96 e Index Edit 57 Observations 22 Add 30 58 Change status on physical exam 56 Delete 33 Update 32 Observations Report 89 Open Physical Exam Report 89 P Patient Advisor and Foundation 5 and Prescription labels 5 Before using 6 Benefits for doctor 2 Customizing 17 Defaults 14 First time you start 6 Getting started 6 Installing 6 Log in 8 What it can do 1 Patient Advisor Setup Information included in 22 Introduction to 21 Locating a diagnosis in 29 Patient Advisor System Setup Report 89 Patient Census 83 Patient Diagnosis Report 89 Patient Diagnosis Status
106. tions E Deafness 5 Disease of the Pinna Update E Neoplasia dane E Otitis Externa Delete E Otitis Intema E Otitis Media Close E Surgery E No Subsystem Specified Search E Otitis Interna System Setup Lx 4 Otitis Media BA LI Surgery Description OK 2 No Subsystem Specified 0 Endocrinology H E Eyes C Gastrointestinal H E Hematology H E Immunology non derm 1 Infectious Diseases 2 Laboratory Biochemistry Urinalysis zi Locating a diagnosis in Patient Advisor Setup 1 In the Patient Advisor Setup window click Search The Diagnostic Codes dialog box appears Choose the desired diagnosis and choose Select The Patient Advisor Setup window returns with the focus on the appropriate system expanded and the diagnosis highlighted For more information on searches see the section The Find Tool F2 in your Cornerstone Reference Manual Related topics Setting up Observations Page 30 Setting up Diagnostic Codes Page 25 Setting up Treatment Templates Page 34 Updating Systems Subsystems Observations and Diagnostic Codes Page 32 Deleting Systems Subsystems Observations and Diagnostic Codes Page 33 Introduction to the Physical Exam Page 45 A guide to using Patient Advisor Customizing Patient Advisor 29 Setting up Observations e Observations designated by a book icon are the symptoms you look for in a normal or abnormal situation Each system includes Normal Did
107. xam Page 78 Saving the Exam Page 80 A guide to using Patient Advisor Using the Physical Exam e 57 Adding Observation Text Line by Line In some cases the observation may need to be customized for a patient You can use existing observation text from Patient Advisor List and add it line by line to the patient s observation You can also add new observations to the Patient Advisor List To add observation text line by line 1 Double click the observation or right click the observation and choose Update The Exam Wizard will display Select the Status normal abnormal or did not examine from the drop down list Click in the Observation box and press F2 or choose the Search button The Observations List will display From the Observation text box select the text to add to the observation Choose Add The observation text will move from the middle box to the lower box Text in the lower box will appear on the Physical Exam Choose Clear to remove any text from the lower box Choose OK to save your changes and return to the Exam Wizard System dialog box Choose Finish to return to the Physical Exam Choose Next to continue with the diagnosis Note You can also click the magnifying glass button highlight the desired line and click Select The new observation text will replace the existing text 3 Timesaver At any point you can choose Finish to return to the Physical Exam and save post or print the Pet Health Report Card a

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