Charm EHR - Patient Record Management

Patient Demographics

Click on the 'Patients' icon in the Dashboard.
Click on the Patient whose demographic details you want to view/edit.
Select the 'Patient Details' option and click on the 'Edit Patient' button.
Make the required changes and click on the 'Update' button.

Medical History

Click on the 'Patients' icon in the Dashboard and select the Patient from the list.
Click on the 'Diagnoses' tab.
Select the 'Active Diagnoses' option from dropbox to view the active list of diagnoses.
Select the 'Diagnosis History' option to view the past medical history of diagnosis.

Health Vitals

Click on the 'Patients' icon.
Select the Patient whose health Vital you need to enter.
Click on the 'Vitals' option and select the '+ Vitals' button.
Choose the date of entry from the 'Date' field and enter the health Vitals of the Patient, viz., Height, Weight, Blood Pressure, etc., and click on the 'Add' button.

Plot Health Vitals

To plot the Health Vitals, click on the 'Plot' option under the 'More Options(...)' icon.
Select the parameter you want to plot from the dropbox. The graph for the parameter will get plotted, which can be printed using the 'Print' option.
You can also import the past health vitals of the Patient using the 'Import Vitals' option.
To do this, create an Excel sheet with the following parameters as comma-separated values. The order should be Date[dd/mm/yyyy], Weight (kgs), Height (cms), Head Circumference (cms), BP Systolic, BP Diastolic, Pulse.
Browse the Excel sheet and click on the 'Import' button to import the past health vitals.

Growth Charts

Growth charts display plotted growth data, such as patient weight, height, and other vitals over time.

To view the Growth Chart of a Patient, go to the 'Patient Dashboard > Vitals' section.
Click on the 'More Options' (...) icon and select the 'Growth Chart' option.
The plotted growth data will be displayed as shown below. You can print the data by clicking on the 'Print' icon.
You can attach the Growth Charts while creating Referral Outs for patients.

Patient Alerts

Critical information about the Patients to alert the Staffs that require special attention can be added as 'Alerts'. The Alerts added to the Patient are highly visible and shown as a pop-up whenever you open the Patient chart. Follow the steps given below to add and manage the Patient Alerts.

Go to 'Patient Dashboard > Alerts' and click on the '+ Alert' button. Also, you can click on the 'Add (+)' icon above and click on the 'Alert' menu.
Enter the Alert description. You can also add the commonly used Alerts in your Practice to the 'Alert Master List' to search quickly and add the Alerts from the master list instead of typing them for each Patient. If the Patient has some linked Patients (family members), you can add the Alert to all of them.
When the Patient has some Alerts added, it will be shown as a pop-up whenever you open the Patient chart. Alert notifications are shown in other sections as well while searching Patients, booking Appointments, etc.
You can also manage the 'Alert Master List' from the 'Settings > Patient > Alerts' section.

Prescription

Add Prescription

Click on the 'Patients' icon and select the Patient from the list.
Select the 'Medications' option and click on the '+Prescription' button.
Search for the Drug name to prescribe from the Drug database. You can search using the Strength, Route, and Dose Form filters.
You can also search for the Custom Drug name by enabling the 'Is Custom' checkbox. All the added Custom drugs get listed.
Click on the 'Prescribe' option to prescribe the appropriate Drug. Enter the details and use the 'Add' or 'Add & Sign' button to add the Prescription.
A pop-up will appear to Sign the Prescription. Click on the 'Sign' button. You cannot delete the signed Prescription. Instead, you can use the 'Void' option to void the Prescription.
If the Drug name that you need to prescribe is not given in the database, you can add a Custom drug by using the 'Add a new Custom Drug' option.
Enter the Drug Type viz., Compounded, Supplies, or Drug.
Compounding includes the combining of two or more drugs. You can customize a Medication with two or more drugs to fit a unique need of a patient. Add the ingredients' names and their strength. The NDC value and DEA schedule get auto-populated based on the ingredients added. For e-prescription, CSA is mandatory. Enter the appropriate CSA and NDC values for the Custom Drug. Enter the intake details and click on the 'Add & Sign' button to sign the Prescription.
If you need to prescribe a custom Drug, choose the Type as 'Drug' from the dropdown. As a first step, look out for your drug in the Prescription Search View. Add free-text drug only if you are not able to locate the drug in our standard Drug DB search. On adding a free-text drug, get valid Drug Description, NDC, and CSA values from proper drug resources like FDA. Considering patient health and safety, we have implemented additional validations in drug description and NDC fields.
To prescribe Medical Supplies, choose the Drug Type as 'Supplies' and enter the Supply details. For Supplies, NDC value and DEA schedule are not required to e-Prescribe.
Click on the 'Add & Sign' button to add and sign the Custom Drug.
You can also add the Prescription from the 'Templates' option.
Add the Prescription from the Practice Templates or My Templates.
You can prescribe the drugs from Past Prescriptions. Click on the 'Past Rx' option.
Choose the Prescriptions either from the Patient Dashboard or from a particular Date from the dropdown menu. You can either prescribe all the Medications by clicking on the 'Repeat all' button or prescribe only the selected Medication by clicking on the 'Repeat' button against the Medication.

Transmit Prescription

Signed Prescriptions can be transmitted either by Paper or Fax. To transmit the Prescription, follow the steps given below.

Click on the 'Transmit' button shown in the screenshot below.
To send a Paper Rx, select the 'Paper Rx' option. Select the 'Rx Print Format' option and click on the 'Transmit' button.
To send the Prescriptions electronically, select the 'Fax Rx' option under the 'Transmit' button.
Choose the Drugs to transmit and click on the 'Select Pharmacy' button.
Choose your preferred Pharmacy name from the Pharmacy Directory. You can also search for Pharmacy with Address, Zipcode, Phone number, and Fax.
Click on the 'Send' button to transmit the Prescription electronically.
You can view the transmitted Prescriptions under the 'Medications' section of the Patient Dashboard with the status 'eFaxed' and 'Paper Rx'.
Once transmitted, you can only edit the Status, From Date, To Date, and Internal Comments fields by clicking on the 'Edit' icon against the prescribed Drug.
You can Re-Prescribe the Drug to the Patient by clicking on the 'Re-Prescribe' option under the 'More Options' (...) icon.
The strength of the prescribed drug can be modified from the Patient's Medications section using the 'Modify' option.

This option lists all the available strengths of the drug. Selecting another strength from the list opens the prescription view. Values for the prescription fields are automatically copied from the original prescription. Adding this prescription will make the original prescription inactive.

e-Prescribing

Charm EHR offers two solutions for ePrescription.

Electronic Prescription of Controlled Substances (EPCS): This solution is used to ePrescribe Controlled substance drugs, as well as non-controlled drugs. Please visit our EPCS link to know more details.
eRX: This solution is used to ePrescribe only Non-Controlled Substance drugs. Our video tutorial explains the steps involved in enabling the eRx solution for prescribers. You can either opt for EPCS or eRX prescriptions. Practice Admin can enable eRx for the Prescribers from the 'Settings > Rx > eRx' section. NPI number is mandatory to enable eRx for the Prescribers.

To e-prescribe, follow the steps given below.

Go to the 'Patient Dashboard > Medications > Add Prescription > Add Rx' section.
Prescriptions can also be added while creating any of the four types of encounters and Quick Rx.
Search and Add the Drug from the database. Follow the steps given in the 'Add Prescriptions' section.
Click on the 'Prescribe' option. Choose the Health Plan Benefit Details as shown below and click on the 'Proceed' button.
Enter the dosage of the drug, dispensing details, additional refills, and other necessary details.
If you need to change the preferred Pharmacy Details, click on the 'Change' option. Search and select the Pharmacy from the Pharmacy database and set it as a Preferred Pharmacy.
On selecting the Pharmacy, click on the 'Add & Sign' button.
Check the details and click on the 'Sign & ePrescribe' button
The Rx Fill Indicator informs the Pharmacy to fill status notifications for a specific Patient/Medication. Choose the appropriate Rx Fill Indicator from the dropdown menu if enabled to receive notifications accordingly under the 'Home Page > Prescriptions > Rx Fill Notifications' section. Click on the 'Send' button.
You can also transmit the Prescriptions by clicking on the 'eRX' option under the 'Transmit' dropdown. Upon successful transmission of the Prescriptions, the status gets changed to 'eRX sent'.
You can view the list of medications transmitted electronically under the 'Medications' section with the 'ePrescribed' status.
Go to the 'Home Page > Prescriptions > eRx sent' section to view the status of all the Prescriptions sent electronically.
Click on the Prescription to view the complete details as shown below.
You can also change the Rx Fill Indicator by clicking on the 'Change Rx Fill Indicator' option under the 'More Options' (...) icon.

Medications

Click on the 'Patients' icon and select the Patient from the list.
Select the 'Medications' option and click on the 'Add Medication' button.
Search for the drug name from the master list. You can use the Strength, Route, and Dose Form filters to refine the search results. Click on the 'Add' button against the Product name.
Enter the Directions, From date, To date, and Status of the Medication. Click on the 'Add' button to add the Medication.
You can edit the Status of the Medication by clicking on the dropdown menu as shown below.
If you could not find the drug in the master list while adding Medications, you can add it as a 'Custom Drug' by clicking on the 'Add a new Custom Drug' option.
Enter the Drug Type viz., Compounded or Drug, Drug Name, Strength, Route, Dose Form, DEA Schedule, and Intake details. Click on the 'Add' button to add the Custom Drug to the Medication.

Questionnaires

Click on the 'Patients' icon and select the Patient.
Go to the Patient Details.
Click on the 'Questionnaires' tab.
You can view all the filled-up Questionnaires by the Patient.

Opioid Risk Tool Questionnaires

Our Opioid Risk Tool (ORT) Questionnaire allows Practices to access a Patient's Opioid Risk Score effortlessly. This score helps Providers in deciding on prescribing Controlled-Substances/Opioids.

The Practice Admin or Office Manager can enable ORT Questionnaire for your Practice using the steps below:

Go to Settings > Encounter > Preferences section
Choose 'Yes' for the 'Enable Opioid Risk Tool (ORT) questionnaire and score in my chart note' option.
Click on the 'Save' button.

Once enabled, you can view the gender-specific ORT questionnaires in the 'Settings > Practice Questionnaires' section.
Questionnaire Details

Charm ORT questionnaires contain the standard ORT questions with Yes/No type answers. Thus, you cannot modify these questions.

While adding this questionnaire as a part of appointment booking or through Kiosk, an ORT questionnaire gets displayed based on the Patient gender. The Patient can fill out the ORT questionnaire on the Kiosk directly.

Also, you can share the ORT questionnaire with the Patient alongside other Questionnaires/Consent Forms while creating an appointment. The Patients can fill it out from their respective PHR accounts. You can view the filled questionnaire in the Patient > Patient Details > Questionnaires section.

Once the Patient fills in the questionnaire, Providers can view the Opioid Risk Score in the Chart Note and Medications sections while adding prescriptions.

Note: Patients cannot view their Opioid Risk Score.

Additionally, you can customize the Patient Face Sheet to display the Patient's Opioid Risk Score. Also, the latest score is visible in the Flowsheet. Clicking on the Opioid Score section lists the Patient's ORT questionnaire history.
Enable Opioid Scores

Note: We do not recommend relying on the questionnaire for making a final call. Providers can use the additional input as a reference while writing prescriptions.

Reconcile the Patient Records

You can Reconcile the data filled by the Patient with their existing records in the EHR by clicking the 'Reconcile' button.
Reconcile Questionnaire

Data filled by Patients can be seamlessly reconciled and added to their respective records in the EHR, instead of manually copying them one by one.

To reconcile the data, follow the step given below.

Create Questionnaires using widgets
Fill out the Questionnaire from the Patient Portal
Reconcile the filled data in EHR

Create Questionnaires using Widgets

Go to the 'Settings > Questionnaires > Practice Questionnaire' section.
Edit an existing Questionnaire or click on the ‘New Questionnaire’ button to create a new Questionnaire.
Click on the ‘+ Add Items’ button.
Add the required widgets (Allergies, Medications, and Supplements) and 'Save' the Questionnaire.
You can share the questionnaire with patients while booking an appointment or use the 'Message > Compose Questionnaire' option to send questionnaires without an appointment.

Fill the Questionnaire from Patient Portal

Questionnaires shared with the Patients are listed under the 'Patient Portal > Questionnaires' section.
Patient Portal Questionnaire

The widgets included in the Questionnaire allow the Patients to fill in their active Allergies, Medications, and Supplements as shown below.
Patient History Questionnaire

After entering the details, click on the ‘Submit’ button.

Reconcile the filled data in EHR

Questionnaires filled by the Patients through the Patient Portal are accessible from the 'Encounter > Questionnaires' section and as well as from the 'Patient Details > Questionnaires' section.

For Questionnaires with Allergy, Medication, or Supplement widgets, an option is provided to reconcile the data filled by the Patient with their existing records in the EHR.

Once the Patient checks in for Consultation, the Nursing Staff can reconfirm the details with the Patient and then use the ‘Reconcile’ option to update the records.

The ‘Reconcile Patient Records’ window lists the data filled by the Patients in Questionnaire and the data present in the EHR together.

Data filled in the Questionnaire are shown in a different color to distinguish them from the Patient’s existing records in the EHR.
Reconcile Patient Records

Use the ‘Add All’ or individual ‘Add’ options to add the Questionnaire data to Patient records in the EHR.
If some corrections are required before adding, use the ‘Edit & Add’ option.
If there are some invalid entries, use the ‘Ignore’ or ‘Ignore All’ options.
In addition, you can also ‘Inactivate’ some of the existing Patient records in the EHR if they are no longer active.

Once reconciled, click on the ‘Preview’ button to preview all the actions performed in the previous step.
Reconcile Patient Records

After reviewing the data click on the ‘Save’ button to update the Patient record in the EHR.

Allergies

Go to the 'Patient Dashboard > Allergies' section and click on the '+ Allergies' button.
If the patient is allergic to any Drug/Food/Environmental factors, it can be added to this section.
Add the Allergens to the 'Allergen' field and choose the 'Type' of Allergy. You can also include more details such as when the Allergy was observed, the severity of the Allergy, etc.
Click on the 'Add' button to add the Allergies for the Patient.

Insurance Details

Click on the 'Patients' icon and select the Patient whose insurance details need to be filled in.
Click on 'Patient Details' and select the 'Insurance' tab.
Click on the '+ Insurance' button.
Enter the Insurance details of the selected Patient. The Payers added under the 'Settings > Billing-Claims > Payers > + Payer' section will get auto-suggested in the 'Name' field under the Payer Details.
You can also add multiple Prior Authorization numbers specific to each Specialty.
The Insurance details will get added.

Pharmacy

Go to Patient Dashboard > Patient Details > Pharmacy
Click on the 'Add' option against the e-Rx Pharmacy.
Search for the Pharmacy name and add it to the list of e-Rx Pharmacies.
You can also add a Custom Pharmacy using the 'Add' option against the 'Custom Pharmacy' section or select from the Pharmacy Directory.

Patient Face Sheet

The Practitioner can get a quick overview of the Patient by viewing the Patient's 'Face Sheet'.

Go to the Patient Dashboard and click on the 'Face Sheet' to view the summary of the Patient.
You can customize the Face sheet by clicking on the 'Customize' button.
Select the sections you need in the Face Sheet.
You can also Print and Download the Face Sheet from the options given above.

Timeline View

A Timeline view shows the Patient's medical records in a picture. Records included in the Timeline view are Appointments, Intake Forms, Encounters, Diagnoses, Prescription, Lab Orders, Image Orders, Referrals, Lab Results, Image Results, and Messages.

Go to the Patient Dashboard and click on the 'Timeline' tab.
The Timeline will appear as shown below. Records are shown in chronological order with the recent entries on the top.
You can also filter a particular section of the timeline you want to view.

Patient Management

Patient Records