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How to Build Templates in EMR/EDR

This guide will cover how to build a template in EMR/EDR. In this article we'll be continuing with the assumption that you have already familiarized yourself with EMR/EDR. If you have not, please refer to How to Use EMR & EDR for a basic guide. You can also consult the video guide for EMR & EDR

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A Template is made up of Form Sections, while Form Sections consist of Form Elements arranged together. We will cover how to build Form Sections, and then show how to assemble these Form Sections to make up a Template which you can then use to generate Patient Forms.
Before building a new Template, we strongly recommend that you first review all Shared Forms first to see if there is already a Template built for your purpose.
If you do not feel comfortable creating your own Templates, our MacPractice Forms Specialists are also available to construct Templates for your office. There may be a fee associated. Please contact MacPractice Support and ask to speak to a Forms Specialist for more information and pricing details.
And as always, if you run into any issues with building Templates, feel free to contact Support for assistance!

Good Design Practice for EMR Forms
Before we address building a Form Section, it is important to keep a few things in mind to get the most out of building an EMR Template.

  1. Keep your Form Sections small. When you are building Form Sections, there is a temptation to make the Sections very large and filled to the brim with all the information you could possibly need.However, smaller Form Sections will help with keeping loading times low when you load up a Template. Smaller Form Sections are typically easier to re-use when assembling Templates, as you can use smaller sections as building blocks, whereas a large Form Section is likely built for one specific purpose.
  2. When you need to edit a Form Section and/or a Template that has been used and therefore is connected to Patient Forms, don't edit the Form Section directly. Duplicate it. Editing a Form Section or Template that is connected to Patient Forms has the potential of data loss, as the connected Patient Form may see an Element disappear that had data entered in it.
    Duplicating creates a whole new copy of the Form Section or Template, and thus won't have any Patient Forms connected to it.
  3. Remember to name your Elements! When you are putting together Form Sections, it's easy to forget to name your Elements a name that stands out so when you're editing your Narrative side of a Template, you can easily refer to that Element.
  4. Make sure a Template works well before using them with Patients. This may seem like a no-brainer, but it's very important to test your Template out on a test Patient before beginning to use it in a live environment. It's hard to visualize exactly how a form will appear until you've generated a Patient Form from a Template to see how everything is laid out. 

Building a Form Section
While there are several pre-built Form Sections that are available to assemble templates, we'll first discuss how to build your own Form Section.
To create a new Form Section, click on the Form Section node in the EMR Sidebar, and then click the Green Plus. This will create a new record.

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Form Section Palette
The Forms Section Palette (visible on the right side of the MacPractice window in the above screenshot) is used to add Elements to the Form Section, as well as customize how large the section is. You can also add in Pull Fields, which are elements that "pull in" information from other areas in MacPractice.
If the Forms Section Palette is not visible, you can toggle it by holding Command-Shift, and pressing K on your keyboard.
Note: If you keep losing your Form Section Palette, you can force the Palette to be visible by checking "Keep palettes on top of other windows" in Preferences > EDR > General.
The Form Section Palette contains many different configuration options. It is split into four parts that you can expand or contract. 

  • The Form Section part at the top allows you to set the name and size of the Form Section, enabling and disabling the grid view, and allows you to choose whether the section will be included on the narrative or the Navigation Menu. You can also use the Set Tab Order function to re-organize the flow of the Form Section.

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  • Inspector allows you to adjust details of the Form Element selected in the Form Section. These options are contextual based on the Form Element selected, but they commonly include positioning and resizing, marking as a required field, or restrict entry to particular characters or numbers.
    Screen_Shot_2017-03-29_at_4.10.00_PM.png

  • Form Elements contains all the different Form Elements that you can add to your Form Section.  There are a variety of fields that you can use to build a wide variety of forms.
    Screen_Shot_2017-03-29_at_4.10.38_PM.png
    To add a Form Element to your Form Section, you can simply drag and drop it from the Form Section Palette to the Form Section. Alternatively, you can left click the desired Form Element, and then drag and drop a position on the Form Section to drop in the field at that location.
    For Elements like the drop down menu, pop-up button, checkboxes, and similar fields, you will need to use the Inspector in the Form Section Palette to add selectable options. You can also add in options that link to References in MacPractice.

  • Pull Fields allow you to "pull in" information from other portions of MacPractice. You can add in a variety of Pull Fields that will pull in patient address information, appointment information. A safe bet is to assume the majority of information within the Patient Ability can be pulled into the form automatically. To use them, you simply drag and drop the pull field onto the Form Section.
    Screen_Shot_2017-03-29_at_4.21.48_PM.png

Adding Elements and Pull Fields
After familiarizing ourselves with the Form Section Palette, we can start using it to start assembling Elements to create a Form Section.We will walk through each step in creating a simple header for a patient who has just arrived at a practice.
Let's say we want to assemble a form section that pulls in the Patient's name, a few demographic details, and asks if they have been to the office before and what they're in for today. We've already discussed how to create a new Form Section in Building a Form Section.
First, let's add some Label Elements and Pull Fields to pull in the demographic information we're looking for. In the Form Elements area of the Form Section Palette, you can drag and drop an Element into place. You can also review the Pull Fields area and drag and drop the desired Pull Fields to your new Form Section.
Note: It is VERY important to name your Elements! This is essential when we address building the narrative side of any EMR Template.
Once the Elements and Pull Fields are placed on the Form Section, you can resize them by left clicking on the Element and clicking on the orange "boxes" to resize that part.
If you wish to edit the contents of an Element, double click the Element.
If you need to duplicate an element, you can hold the Option key and click on the Element.
If you ever need to remove an element, you can simply click the element, and press the Delete key on your keyboard.

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Codified Elements
There are several Elements in the Form Elements area that are Codified Elements. These Elements link to different areas of MacPractice and have the advantage of being able to directly access different areas of the software.

These Codified Elements are...

  • Diagnoses and Billing
  • Vitals
  • Allergies
  • Race and Ethnicity
  • Problem List
  • CQM Supplemental Info
  • Family History
  • Chief Complaint
  • Clinical Instruction
  • Immunization
  • Smoking Status

Codified Elements are very useful because they can save you work. For example, if I add an allergy to Tylenol to the Allergies Codified Element on a Patient Form, when the Patient Form is saved that allergy will be posted to the Patient's Clinical Tab under Allergies. Because of this, we strongly recommend that you use Codified Elements whenever possible to streamline your workflow.

Set Tab Order
By clicking the Set Tab Order in the Form Section Palette, you can determine the flow of the Form Section by controlling the order of tabbing from field to field.

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When you first click Set Tab Order, you can see blue numbers by each entry field, as appears in the animated image above. This indicates the original tab order. From here, you can click the entry fields in order to set a new tab order. These numbers assigned will appear Purple initially, as seen in the image above. When you click "Done", the new Tab Order is set.

A Word About Editing and Removing Form Sections In Use
It's important to note that editing a Form Section that is in use in a Template that has Patient Forms generated from it can potentially cause you to lose data. This is why a Form Section is locked when you save it, to ensure you do not accidentally edit a Form Section that may be in use. We advise if you ever need to adjust a Template currently in use, you duplicate the Form Sections and Templates, and make the adjustments on the duplicated form. This will retain the older versions, and thus the Patient Form data generated from those older versions.

Narratives and Templates
Once you are done assembling Form Sections or you have decided on the pre-built Form Sections you want to use, you're ready to assemble Narratives and Templates.

Editing the Narrative
A Narrative is essentially a text readout of all the entry fields in a Form Section that can be parsed much quicker than reviewing the form itself. However, in order to have a Narrative that reads well, we need to adjust the Narrative input to ensure that the information pulls through in a readable format.
It is very important to have your Form Elements named in a way that you can easily identify them when editing the Narrative!
In order to flip a Form Section over to the Narrative side, press Command-\ on your keyboard, or you can flip  to the Narrative by selecting "Toggle Narrative/Form" in the EMR/EDR Menu.
For example, my Example Form Section here appears like so on the Form view...

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As you can see, I have two pull fields for First Name and Last Name, I have a drop down box for answering the "Is this your first visit with us?" question, and then I have a Purpose of Visit Text Field. These are labeled in a clear fashion so we can understand what they are.
Note that the Label above Last Name Pull Field and First Name Pull Field doesn't denote it's a label. This is because the name of a Label is what displays on the form.
Let's take a look now at how this Form Section appears on the Narrative side.

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The Narrative view appears as a simple text editor. You can see each element in brackets, including the labels we have for the form itself. The Brackets indicate that the information from that Element will be placed at the position of the brackets. So for example, the above information would appear like so on a Patient Form.

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While this contains the information of the Form Section, it's broken up and not easily readable. This is because we haven't edited the Narrative to make it more readable.
There are many ways to approach this, the easiest is to either remove the labels from the Narrative itself and type up how you'd like the Narrative to display, or you move the labels to more logical locations.
For example, I am going to clear out the Labels in the Narrative so we just have the Pull Fields, and then we'll type out how we want those questions and answers to appear. 

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As you can see, this strips away the extraneous Labels to avoid confusion, and adds them in with plain text. The Narrative here will appear as such in a live environment:

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This is a much cleaner Narrative, and is much easier to read.
Note: If you ever delete a pull field in the Narrative view by accident, you can re-create it by typing the name of the pull field exactly, with the same capitalization and same punctuation. You then enclose the pull field with { }s. 

Building a Template
To create a new Template, simply select a Category Node (the red nodes) in the Sidebar, and click the Green Plus at the top of the Sidebar. You can then name the Form in the Form Palette that appears in the right side of the image below.

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To assemble a Template we will select our Template then click and drag our desired Form Sections, one at a time, to the template pane. If successful, the section will appear immediately there, as well as in the Navigation Menu on the right side.

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