EHR · TRANXACT Help

Care Delivery

Where the patient is seen and treated.

Clinical

9

Charting, order entry, decision support and care planning.

RecordsPatientsOpen ViewPossible Duplicate PatientsEvery patient whose name matches another record together with the date of birth or an email or phone. Open both to compare. Different people: choose Not a duplicate and say why (or say why when saving with Create anyway), and the pair leaves this list.Open RecordsClinical DocumentationA signed note is the legal record: it is never edited, only addended.Open ViewOrder Entry (CPOE)Orders run through decision support before they are written. A contraindication stops the order unless it is overridden with a reason.Open RecordsCare PlanningThe plan, its goals and who is accountable. Goals carry a measure and a target.Open RecordsOrder SetsStanding orders, so a chest-pain workup is one action rather than five.Open ViewDecision Support AlertsEvery alert that fired, and whether it was accepted or overridden. A high override rate says the alerts are being ignored.Open ReportClinical QualityDocumentation completeness, decision-support override rate and laboratory quality.Open ViewMedication ReconciliationAt admission, transfer, discharge or a visit: what the patient takes at home, what is ordered here and what other systems sent, side by side, a decision for each, signed, and the medication list changed to match.Open

Existing Records

6

Encounters, problems, allergies and clinical orders.

RecordsEncountersOpen ViewClinical OrdersOpen ViewMedicationsEvery medication a patient is on or has been on: ordered here with Prescribe (safety checked), or prescribed under Prescribing. A prescription is transmitted, dispensed or stopped on Prescribing.Open RecordsProblem ListOpen RecordsAllergiesOpen ViewResults / ObservationsOpen

Emergency

3

Triage, the live board and disposition.

RecordsEmergency VisitsArrival, triage, treatment and disposition. An ESI of 1 or 2 raises an alert at triage.Open ReportEmergency BoardWho is in the department now, ordered by how sick they are against how long they have waited.Open ReportED ThroughputTime to triage, time to provider and length of stay, by acuity.Open

Operating Theatre

1

Scheduling, the safety checklist and supplies.

RecordsSurgical CasesScheduling refuses a double booking; the safety checklist is a gate, not a form.Open

Rehabilitation

1

Therapy episodes, sessions and goals.

RecordsRehabilitation TherapyPhysical, occupational and speech therapy: episodes, authorized visits and sessions.Open

Behavioral Health

1

Standard instruments that score themselves.

RecordsBehavioral AssessmentsStandard instruments that score and band themselves — PHQ-9, GAD-7, C-SSRS.Open

Diagnostics & Pharmacy

What is ordered, what comes back, and what is dispensed.

Laboratory

3

Orders, results that flag themselves, and quality control.

RecordsLaboratory OrdersOrders, specimens and results. A result flags itself against the reference and critical ranges.Open RecordsLaboratory CatalogTests with their reference and critical ranges — the ranges a result is flagged against.Open ViewLaboratory Quality ControlControl runs. Beyond two standard deviations warns; beyond three fails and results are held.Open

Radiology & Imaging

2

Worklist, image access and reporting.

RecordsImaging WorklistFrom order through acquisition to a signed report. A critical finding raises an alert.Open RecordsImaging CatalogWhat can be ordered, by modality, with its price and preparation.Open

Pharmacy

3

Formulary, interactions, prescribing and dispensing.

RecordsPrescribingWritten, transmitted and dispensed. A controlled substance must be sent electronically or printed.Open RecordsFormularyWhat may be prescribed, with the controlled and high-alert flags that change how it is handled.Open RecordsDrug InteractionsThe pairs decision support checks against when a medication is ordered.Open

E-Prescribing

5

Prescriptions sent to pharmacies, what pharmacies ask back, and who may sign controlled substances.

ViewE-Prescribing MessagesEvery NCPDP SCRIPT message sent to or received from a pharmacy: NewRx, renewals, changes, cancellations, fill notices and the network's status answers, with the raw XML exactly as it travelled.Open ViewPrescriber TasksWhat pharmacies have asked prescribers for: renewals, changes, and refusals to look at. Approving a renewal writes the new prescription and answers the pharmacy.Open RecordsPharmacy DirectoryPharmacies a prescription can be sent to, by NCPDP id: retail, 24-hour, mail order, specialty and long-term care, and whether each takes electronic prescriptions for controlled substances.Open ViewEPCS PermissionsWho may sign electronic prescriptions for controlled substances. Each is requested, then approved by two different people other than the prescriber, at least one of them a DEA registrant (21 CFR 1311.125).Open ViewEPCS Signing LogEvery attempt to sign a controlled-substance prescription, signed or refused, with the factors presented. Append-only.Open

Access & Operations

Getting in the door, and the resources behind it.

Administration

6

Registration, scheduling, resources and compliance.

RecordsSchedulingA booking is refused when the provider or the room is already taken, and schedules its own reminders.Open RecordsResourcesRooms, beds, theatres and equipment that can be booked.Open RecordsClinical DepartmentsEvery department in the organization, with its cost center and its head.Open RecordsProvidersClinicians and the departments they work in. Linked to the HRMS personnel record.Open RecordsCompliance ReportingQuality measures and regulatory returns, with the numerator and denominator behind each rate.Open ReportCalendar InvitationsInvitations sent from appointments: who was invited to what, when, and how often it was sent. Sending again after a change updates the same calendar entry; cancelling removes it from every calendar.Open

Patient Access

5

Portal, telehealth, reminders and education.

RecordsPatient PortalPortal invitations, activation and reminder preferences.Open RecordsTelehealthVirtual visits, their link and how the connection held up.Open RecordsAppointment RemindersScheduled with the booking rather than chased afterwards.Open RecordsPatient EducationMaterial that can be assigned to a patient, matched to their conditions.Open RecordsRecallsPatients to see again by a date. The daily job reminds each patient whose recall falls due and who has nothing booked (if they allow reminders), and marks the ones who have booked.Open

Revenue Cycle

Charge capture, insurance, claims and payment.

Revenue Cycle

6

Charge capture, insurance, claims and payment.

RecordsCharge CaptureWhat was done becomes what is billed. Captured from laboratory, imaging and theatre.Open ViewClaimsBuilt, scrubbed, submitted and adjudicated. What the patient owes becomes a receivable in Accounting.Open RecordsInsurance VerificationCoverage on file, and whether it has been verified. A claim will not pass the scrub without it.Open RecordsPayersWho is billed, and how long they typically take to pay.Open ReportRevenue by PayerBilled, paid, outstanding, denial rate and collection rate.Open RecordsDenial Work QueueEvery denied or rejected claim, opened as a piece of work by the overnight job, with what kind of denial it is and what usually fixes it. Resubmitting sends the corrected claim -- as a replacement when the payer had already adjudicated it.Open

Claims EDI

6

Claims to the clearinghouse, acknowledgements and remittances back, and eligibility.

ViewEDI FilesEvery X12 interchange with the clearinghouse: 837P and 837I claims and 270 inquiries out; 999, 277CA, 835 and 271 in. Control numbers, counts and the raw file.Open ViewRemittancesElectronic remittance advice (835): the payment, the claims it pays, the adjustments and the patient's share, posted to the claims, and whether it all balances.Open ViewClaim AdjustmentsEvery adjustment a payer made on a remittance, by group and reason code (CARC) with its remark codes (RARC).Open ViewEligibility ChecksEach 270 inquiry and the payer's 271 answer: coverage, plan, copay, deductible and what is left of it, coinsurance and out-of-pocket.Open RecordsClearinghouse PayersThe payer ids a clearinghouse routes to, and which transactions each takes.Open RecordsPractice SitesWhere prescribers write from and claims bill from: the group NPI, tax id, taxonomy and address that NCPDP and X12 carry.Open

Patient Billing

4

What patients owe after insurance: statements, payments and dunning.

RecordsStatement RunsOne billing cycle: a statement for every patient with a balance after insurance, aged and dunned, with the ones that should not go held or suppressed and the reason recorded.Open ViewPatient StatementsEvery statement sent, held or suppressed: previous balance, new charges, payments, adjustments, amount due, ageing and the dunning message. A patient with a portal account sees theirs there.Open RecordsPatient PaymentsMoney from patients: copays at the desk, payments, refunds, and adjustments the practice grants.Open RecordsDunning MessagesWhat a statement says, by how old the oldest money on it is.Open

Information & Population

Coding, release, and the health of everybody rather than anybody.

Health Information

2

Coding, release of information and the access log.

RecordsRelease of InformationRecords are not released without an authorization on file, and a release is logged as an access.Open ViewPHI Access LogEvery look at a chart, append-only. An access log that can be edited proves nothing.Open

Public Health

5

Immunization, surveillance and the population.

RecordsImmunizationsWhat was given, when, and what is still due against each series.Open RecordsVaccine CatalogSeries length and intervals — what makes a course complete.Open RecordsDisease SurveillanceReportable conditions, outbreak references and what has yet to be reported.Open ReportImmunizations DueWho has an incomplete series, from the registry.Open ReportPopulation HealthThe panel and its immunization coverage.Open

Interoperability

5

HL7 v2 interfaces, clients of the FHIR API, outside medication lists and network connections.

RecordsHL7 InterfacesTrading partners speaking HL7 v2: ADT, results (ORU), orders (ORM/OML) and pharmacy (RDE), over HTTP, a watched folder, or MLLP (off until switched on).Open ViewHL7 MessagesEvery HL7 v2 message in or out, with the acknowledgement it was given: AA accepted, AE could not be applied, AR rejected.Open ViewFHIR ClientsApplications allowed to use the FHIR R4 API at /fhir/r4, with the scopes each may ask for and the patient or user it is bound to. The secret is shown once.Open RecordsOutside MedicationsMedication lists other systems sent, over FHIR or HL7, kept apart from the medication list until a clinician reconciles them.Open RecordsNetwork ConnectionsSurescripts, clearinghouses and HL7 partners: the transport, the identities in the envelope and the control numbers. Credentials are sealed and never shown again. With no live connection the sandbox answers.Open

Reporting

The catalog over the whole record.

Reporting

2

Executive, management, operational and audit reporting over this module’s records.

ReportReports & AnalyticsThe report catalog for this module, and the models behind it — dimensions and key figures you can rearrange, filter, total and export.Open ReportPredictive & PrescriptiveWhere this module’s measures are heading, how much that projection is worth, and what to do about it while there is still time.Open