Navigation:  Frequently Asked Questions > Using the Software >

Working with Encounters

Previous pageReturn to chapter overviewNext page

Q: I noticed that when a staff logs in, such as Joe Smith, I noticed that the pulled charts display menu will display the patients' names, under the patient name heading; however, it displays "Joe Smith" under the Provider heading. Is it saying that "Joe Smith" is the provider on the record even though Joe Smith is a staff member? Or is that just designating the person who worked on the file? If so, is there a reason for Joe Smith to be under the "Provider" heading? I only set up as me under the provider settings.

A: Until the encounter/report/note is signed, the person who created it will be listed. Once signed, the provider (who presumably should only be allowed to sign off on encounters) will be the listed person.

Q: Is there are drawing capability?

A: Yes, it's part of the Exam Tool.

Q: How do you do a drawing with an exam encounter?

A: Drawings can only be inserted with the Quick Exam Tool. On the right side menu, click the "Quick Exam Tool" menu option. Say for example that you want to add a cornea drawing, you would click the cornea button (when it's Green/Norm) and you will get the Q- Tool screen. The third tab at the top shows the "Drawing Tool". From there you choose the correct Image Template and draw on it just like a regular Paint-type program. Once you hit Save, the software will ask if you want to insert the drawing into your exam notes. Typically you would say yes.

NOTE: There are a few quirks to the drawing module. You can only view one inserted image in the chart at a time (although any additional drawings you make are there and visible in the Image Manager). Also, when you use the undo near the beginning of a drawing, it sometimes clears the template too. Just re-select the template. You can add your own templates with the Customize menu choice at the top menu on the exam encounter.

Q: Is there a Contact lens order or trial contact lens section? Or just a general note section to keep track of any communications w/ the patient?

A: The Contact Lens Tool allows for up to 4 sets of trials per encounter. Also finalized CLx's are tracked in the LogBook tool. Typically doctors incorporate their CL findings & assessments directly into an encounter/SOAP note.

Q: Can you copy forward a previous exam for a patient?

A: You can copy the prior Subjective history (either by selecting Established Patient on the "Quick Fill Template" dropdown at top of Subjective Findings Tool or by clicking the little Find button next to the medical history buttons. You can pull forward prior exam findings, but you can easily cut/paste the entire objective section (or parts of it) if desired.

Q: How do you review previous years chart when you have a new chart open.

A: Click the "Chart Review" button on the bottom left side of chart (it looks like a double headed arrow). From there you can review any prior chart.

Q: Can the chart be resized?

A: In most cases yes. Simply double-click the title bar.

Q: I saw that you had a coding wizard to make sure you've fulfilled to the level you're billing. Does this include (or could it in the future) nursing home E&M codes like 99308. 99309, etc?

A: It doesn't at the moment. I'm not too familiar with those codes, but if you point me to a website that covers the requirements I can look into incorporating a wizard for them.

Q: And does this feature also make sure you've done all the testing necessary to fulfill the 92000 ophthalmic codes?

A: The coding wizard is fairly simple. You click on the boxes of areas you've completed and it will tell you what coding level you are at. It doesn’t, unfortunately, analyze the data as it’s entered.

Q: Is it possible to carry patient info forward from previous records at subsequent encounters or must all be re entered at each encounter?? examples: allergies, family Hx, old spec Rx’s ocular history medications.

A: You bet. This can be done in two ways: (1) by selecting a Patient Type of "Established" from the dropdown list at the top of the subjective tool, which will pull forward the most recent history data or (2) by clicking the little blue arrow next to the history buttons. Note that the little blue arrow will appear throughout the software and is a shortcut for pulling data into the specified tool (if available).

Q: When I attempt pull patient history forward I get "no prior history exists for this patient". Is there something I'm doing wrong?

A: The history will only pull from a FINALIZED encounter. To test this, open the sample patient (Joe Sample) and create an encounter dated last week (use the "Change Date" button that appears in the far right-hand side of the "Open New Encounter" screen). Then create some Medical/Ocular history items (use the Green Button to pre- fill as normal). Then save the tool and SIGN the encounter. It becomes FINALIZED. Close the encounter and create a fresh one with today's date. You can now pull forward the "prior" history.

Q: When it does pull the old data, can it be copied forward to the current encounter? If so, what gets copied? History? Rx, Contact lens, Medicines? The "copy forward" is one of the most significant attributes of EMR and I need to know how it works.

A: Yes, all the medical, ocular, medication, allergy and Rx’s can by “copied forward”.

Q: I do not see where I am able to input data from biomicroscopy and ophthalmoscopy separately for the right and left eyes. I have a lot of pathology in my practice and need to be able to enter information for each eye separately without a lot of typing. Is the program set up to enter information for each eye individually?

A: This can be done easily. For example, click the cornea button, and then uncheck the "normal" text statement. Then right-click the abnormal finding to get the menu and select OD or OS. You can do this with nearly any finding in the exam tool.

Q: My technicians perform non-contact tonometry with multiple readings on each eye. Can I record each reading rather than an average? I also often obtain Goldmann applanation tonometry myself. Is the program able to record both methods on the same exam?

A: The NCT tool (on the Automated Instruments screen) only allows for 2 readings per eye. The doctor can enter his own Goldmann readings using the Tonometry slider on the Exam Tool (second tab). You can also manually add more readings directly in the SOAP note.

Q: When a previous patient returns for a yearly exam, will the program mirror the last exam to use a starting point for the new exam?

A: For history, yes (you just select Previous Patient from the template list on the subjective findings or use the little blue arrow near the history section). For exam findings, not so much. You can cut/paste from prior exams for long verbiage that you don't have pre-defined template text.

Q: I’m concerned about how much time it takes to chart versus just using paper. This seems to take much longer!

A: Believe it or not, you can chart a "normal" patient (say a -2.00 myope) in under 90 seconds. Our software is designed on an "exception to normal" format, so you click less if everything is okay. But you do have to do some work (aka clicking), since part of the template is designed to make sure you don't overlook something important!

It takes time to get fast charting with EMR. My experience (and that of most other doctors) is that it takes LONGER to do an exam with EMR during the first few weeks (or months) as you build familiarity with the software, learn shortcuts, and develop compatible exam practices (such as finding moments that allow for a bit of typing without interrupting exam flow). If you have a great memory, you can do your regular exam and then chart at the end. But if you are like most of us, you have to have a few stopping points to enter relevant data (I do it after discussing history with patient, then after the refraction, and one last time at the end of the exam). Normal patients will become super fast. It's the "abnormal" ones that add time and the whole point of any software system is to make it easier; it's also one of the most complex of programming tasks since EVERY doctor has different ways of doing exams!

Q: When fitting a patient with contact lenses, where is the section where I can fill out how the contact lenses looked on the patient, their visual acuity, etc...?

A: On the left-hand menu in the main chart, click Contact Lens Tool. Enter the contact lens parameters of the CL's you have on the patient’s eyes (using the sliders and dropdown boxes). Then on the right side in the 2nd section down (Lens Evaluation), click the blue arrow to transfer the lens parameters. Then click the Details button to bring up the evaluation screen.

Q: Can a Rx in the LogBook be deleted? I have a long list of testing Rx's that I'd like to erase.

A: Yes. Open the patient Encounter and go to the exam page that shows the Rx LogBook (this is only visible in Exam Sheet mode). From there, right click the Rx and select delete.

Q: Can I bring forward exam data from previous encounters to the next or must all history and exam be re entered with each visit??

A: Here is a synopsis of the various data that can be pulled forward in the current version:


You can bring the patient medical/ocular history forward quite easily. On the Subjective History Tool, on the first tab (Preliminary Findings) you will see a row of boxes near the middle with different history options (e.g. Medical, Ocular, Social, etc). Normally you would use the green arrow to make All Normal, then maybe the Details button to make any exceptions to normal. But if you have a prior history, you would click the Find button (looks like a magnifying glass) right below the green arrow or use the Prior History button at the bottom. To make it even quicker, when you select from the Quick Fill Template list at the top of this same screen, it automatically populates with your most recent history (as well as prior exam date).


You can find a prior Rx and pull it into current lensometry data on the Automated Instrument Tool. Use the Find Prior Rx button on the bottom of the Automated Instrument Tool.


On most of the dioptric power slider tools, you will see a small green arrow near the top left corner. Clicking on it will give a menu of options for importing prior (or current data). For instance, on the Refraction Tool you use the green arrow to pull prior lensometry or autorefraction data forward.


You use the green arrow to import Subjective Refraction findings or maybe a lensometry reading. You would then click the Contact Lens Power Conversions buttons at the bottom to clean up the data. To pull prior years Contact Lens parameters, you would click the large Find Contacts button(s) on the CL tool.


There is no simple way to copy prior exam findings (and you generally wouldn't want to, since they would likely be different). However, you may on occasion want to copy some of the verbiage from a prior record (say a description of a corneal problem). To do this you open the prior chart from within the current chart (by clicking Full Chart on bottom left side of buttons in chart view), then use the dropdown at top to find relevant prior encounter. Use your mouse to select the text you wish to copy and then right-click select "copy" (or just use ctrl-c from keyboard). Close the prior encounters and paste the text into your Soap Note at the appropriate place using ctrl-v or right- click (the background changes to green in edit mode). NOTE: Try not to delete any of the Anchor Tags (that have curly brackets like this: "{Cornea}") as these are used to create your remaining exam findings


Currently the software does not pull these forward. This will be addressed in an upcoming version. Also we will likely add an alert if the entered tonometry and c/d doesn't match a prior finding.

Q: I enter chart data, but when my staff looks at it they can’t open the chart.

A: You must have the security settings of the User set high enough that they can view Pending charts (usually level 7 or higher).

Q: I can't seem to figure out how to put a previous prescription in correctly (from an exam from 2005). When I put in the prescription and change the date, it does not save the correct date but puts in today's date. Thanks for your help.

A: I tested that out and you are correct, the date seems to revert to today's date. You can correct the date on the report itself by manually editing it on- screen and then when saving, changing to the correct date. That way the printout that is save in the chart will be correct. However, the Rx Logbook will show the incorrect date, and as of yet there is no way to edit it.

Q: Cannot find the ADD area or button to attach an ADD to the SRx when using the refraction tool. I can use the prescription viewer to add it in later, but a button or place in the refraction tool would be useful.

A: With the 'Refractive Findings Tool', the slider near the bottom gives the Add powers... changing should change the two boxes marked 0.00 to the correct Add power. The range is hard-wired at +0.75 to +4.00. Clicking the actual (green) box once you have entered the Add causes it to reset (blank). To enter unequal adds, click the small red circle that is located in the bottom left part of the Add Power slider.

Q: I have trouble pulling up the Drawing template for like fundus or externals, etc when I am in the exam record. It does not give the template but just brings up a blank Paint screen. (I am using Vista, will the drawing module work with XP better?)

A: You are going about it the wrong way. For example, a cornea drawing can be done by: open the Quick Exam Tool, then click the Anterior Segment tab. Click the cornea button twice to pull up the Detailed Findings section and across the top tabs you see on called "Drawing Tool". This is the one you want to use for all your drawings. It has the advantage of pasting your drawing into the exam record in the appropriate section, if desired. Any of the buttons on the Quick Exam Tool work this way.

Q: Is it easy to link a patient's ezChartWriter record to previously scanned records (e.g. PDF's)? I believe there was a section, but I think that it was reserved for "Future Use." Can't remember exactly what it says, my demo is expired.

A: Yes. You use the Document Manager to "attach" the document. Simply right-click the patient's name and select "Attach Document".