LibreHealth EHR User Guide

Introduction

The purpose of this user guide is to introduce you to the basic appearance and features of LibreHealth EHR. We’ll walk you through the different screens and focus on the different functionalities that will help you run your electronic health record keeping smoothly and efficiently.

There are three main sections that we will explore: Login, User Preferences, and Menu Navigation.

In this section, we’ll begin with the Login Screen and then look at the interface and basic navigation functions within LibreHealth EHR.

In the User Preferences section, we will explore the various methods to change the look and feel of your personal working environment to your preferred interface.

In the Main Navigation section, we will explore the various screens and tools on the top menu bar of the Main Screen.

You can jump to a specific section from the Table of Contents links.

Toni Shortsleeve, LibreHealth EHR Documentation Intern, March 27, 2018

Login

You will first see the Login Screen:

In the lower right corner of the screen you will see the Libre version number. This is good to know if you need to ask for technical support.

Next to the version number you will see a link that will take you to the Acknowledgments, Licensing and Contributions information.

Below the Username and Pass Phrase is the Language dropdown menu. You can change the display language. Standard English is Default.

In this documentation, the user will be an Administrator so that you can see all of Libre’s features.

Each user’s access and permissions determines what that user can and can’t see.

Enter your Username and Pass Phrase then click on the Login button.

This will take you to the Main Screen.

Main Screen

Note: Patient and staff names or any data you may see are completely fictional.

You will see the main menu along the top. Each menu item is the name of a menu group. We will explore these shortly.

Below the main menu is the Header area in which the active patient's information is displayed when their record is being worked on. At the moment it says Patient: None. That will change once a patient is chosen.

LibreHealth EHR starts with two panels. Each user has some choice of which ones appear for them. You can find out more in the User Preferences section.

The number of panels you see will change as you open and close modules.

The Module Panels present the controls you work with in each of LibreHealth EHR’s different functions.

Each Panels Tab has controls on them, as you can see with the Calendar Module Panel.

The round arrow icon on the left will refresh the module.

The lock will close the panel, and keep it floating above the open panels as they move in to take up the space. Clicking the lock again will re-open the panel in its original location.

The “X” will close the panel entirely. As with the lock, the open panels will move in to the empty space.

When you select a menu item that opens a new panel, it will be seen to the right of the other panels.

Some of the panels are wider than others. If you have more multiple panels open, they may take up too much room and seem to squeeze together. If this occurs, you will see scroll bars so that you may still navigate on the panel of your choice.

Now that we have a better idea of how the screen flow works, we’ll visit the User Preferences to create your favorite working environment.

LibreHealth EHR User Preferences

As the user, you can change the default settings and control what you see when the Main screen first opens.

You can only set your own preferences. You will not be able to modify the default system settings for any other user.

We will begin to define our User Preferences from the Main Screen which we saw in the Login section.

The User Image at the top right of the screen is the Authorization Group dropdown menu to access your preferences.

You will see the name of the current user whose preferences are being changed. In this case it is “Administrator Administrator”.

First we will choose User Preferences.

You will see the Edit User Settings panel drop in to the right of the screen.

Each tab at the top of the Edit User Settings panel will open a new screen. Each opened tab will change to a different color so that you can easily see what section you are working with.

Note: To preserve your changes, you must hit Save before opening a new panel.

We’ll go through the choices from left to right, beginning with the Appearance section.

Appearance

The first tab on the panel is the Appearance section. Each row of choices has four columns. The first column column gives the name of the item to be changed. The second column has a dropdown menu of choices. The actual Default is shown in red next to that menu. The checkbox is checked to show you approve the Default.

If you prefer to see a different setting than the Default, choose a different menu item and uncheck the checkbox:

In this case, we used the Default First Tab to choose to see the Patient Flow Board before the Calendar Screen.

By default, the second tab will open the Messages panel. This can be changed just as we did with the Default First Tab.

The Role-based Menu manages the staffing permissions of the user. The Answering Service does not need the same access as the Front Office or Clinical Staff.

The Theme determines the look of the screens. Default is the color tan. You can also choose Light, Prism, Purple, Tan with no icons, or Metal.

By Default, your Patient List Page Size is 50. You can change this to any number of names that you are comfortable looking at, even 100.

The Default choice is to have your Patient List Page not open in a new window. You can change this by checking on the box next to the option. This will uncheck the Default setting.

When you are happy with your Appearance choices, remember to click on Save so that it will be there on your next Login.

The next tab we will visit is Locale.

Locale

Locale allows you to choose the method of showing measurements, date and time display formats, based upon your local preferences. Default is set for the United States formats.

Notice that we have only changed the Date and Time formats.

Once you have changed this page to your satisfaction, remember to Save.

The next tab we will visit is Report.

Report

The Report screen lets you choose the Beginning Date for the Ledger Report. Default is One Year Ago, however you may choose from yesterday to Two Years ago.

You may also choose to Print the Next Appointment on the Bottom of the Ledger.

Once you have changed this page to your satisfaction, remember to Save.

The next tab we will visit is Demographic.

Demographic

The Demographic Screen allows you to choose when to be notified with alerts about User Messages and Patient Allergies.

You can set the Display timer for 20 to 50 seconds.

Once you have changed this page to your satisfaction, remember to Save.

The next tab we will visit is Encounter.

Encounter

The Encounter screen allows you to choose between the Clinical View and the Billing View. The Clinical View is the Default setting.

Once you have changed this page to your satisfaction, remember to Save.

The next tab we will visit is Calendar.

Calendar

On the Calendar Editing Settings screen, you can change the appearance and actions of the Calendar.

The frequency that the Calendar refreshes can be set from 1 to 10 minutes or not at all.

The View can be by Agenda format of 1-Day, 2-Day, Weekly format or Monthly format.

The event colors can be shown by Category or by Facility. You can also choose to show specific information in the Patient Flow Board.

Remember to click on Save.

Now that we’ve update our User Preferences, let’s look at changing your Pass Phrase.

Pass Phrase

You may wish to change your login password.

Go back to the User Image at the top right of the screen in the Authorization Group and choose Change Pass Phrase. This will open the Pass Phrase Change screen.

Enter your Full Name, Username and Current Pass Phrase.

Now enter your new Pass Phrase and repeat the new Pass Phrase to confirm.

Save your settings.

You may want to Logout and return to make sure your new Pass Phrase works as expected.

Logout

To Logout from the LibreHealth EHR, go back to the User Image at the top right of the screen in the Authorization Group and choose Logout. This will take you back to the LibreHealth EHR Login page.

You will need to log out and log back in to see these new user preferences in action.

Now that you have set your working preferences, let’s review the Navigation of the Main Screen.

LibreHealth EHR Menu Navigation

The purpose of this section is to understand the navigation of the Main Screen Menus in LibreHealth EHR.

We’ll explore and work with the Menu Items on the Main Screen. For most Menu Groups of more than one option, we’ll also look at their respective Menu Items.

Calendar

The first menu item at the top left is the Calendar. When you open the calendar you will see the patient appointments scheduled for your facility.

Any user who has the calendar checkbox selected in their User Profile will appear on the Calendar.

There are two ways to select the date to view. You can use the Date Picker to choose Month, Day and Year.

You can also use the controls to choose today, arrow back to previous dates, or arrow forward to future dates.

If your LibreHealth EHR supports more than one facility, default shows All Facilities.

Underneath the Date Picker and above the Users List, you will see the All Facilities dropdown list.

Below the Users List, you will see each Facility that is currently in use.

You can select which Facility schedule you wish to look at, and see only the providers who are assigned to that facility. Let’s look at the North East Clinic.

The Facility dropdown list now shows the current facility as North East Clinic.

Notice that Virginia Apgar is not on the User List and we do not see her on the Calendar. This is because Virginia is at the South West Practice and not at the North East Clinic.

At the top right of the calendar are the types of calendar displays. The default is the 1 day Agenda view. This will show appointments for all providers for that day.

This is the 2 day view of the South West Practice provider.

You can also view the calendar by Week and Month by choosing the week or month tab.

You can choose to view specific users from the Users List by clicking on the user’s name. If you want to see multiple users, hold down the ctrl key as you click on the names you want.

As we view a day’s agenda at all facilities we will see the various scheduling types.

Administrator has a meeting and then a personal time scheduled. Dr. Miked has two different consultation types before lunch. Dr. Apgar has two patients before an early lunch.

These color codes make it easy to recognize the types of events of the day.

Now that we understand the Calendar, we’re ready to explore the next important menu item, the Patient Flow Board.

Flow Board

To the right of the Menu Item Calendar, is the Flow Board.

The Flow Board is a useful method of tracking the current status of every patient’s progress through their appointment.

The status of the patient’s encounter, appointment or visit is updated as they progress through it.

The different data about the status can be seen under each column.

The Flow Board module monitors the time each patient spends in each status to use in report generation and clinic performance analysis.

Now let’s explore Messages.

Messages

The next menu item is Messages, located to the right of the Flow Board.

This is the module with which the staff communicates non-clinical information with each other. In American law, these messages are not part of the patient's medical record. But that may not be the case where you are.

If you do have messages waiting for you, you will see a message notice on the menu bar next to the user icon.

You can choose either the Messages menu item or the message notice to open the Message and Reminder Center.

You can view of the messages in your history, both active and inactive by choosing Show All. You can choose to see only the active messages that need your attention by clicking on Show Active. You can also review the previous messages by clicking to Show Inactive.

To create a new message, choose the Add New button.

This will open a new panel that will allow you to begin compiling your message.

The Type of message you will send is chosen through the Type dropdown menu.

Click inside the Patient text box. This will open a Patient Search module.

You can choose to search by Name, Phone, Patient ID number, social security number of Date of Birth. Enter the first few characters inside the For box and press the Search button. There may be more than one patient whose name begins with the first few letters. Click on the name of the patient that this message will be referring to.

Now that we have chosen the type and patient, we have a dropdown menu to choose the status of a the status. In this case we will Forward this letter to another staff member.

Use the dropdown to select the user or the patient that should receive this message. In this case, Administrator is sending to Virginia Apgar, Mike Miked. By clicking on the names one at a time, they will be entered with each recipient separated by semicolons.

Once the message is composed, you can send the message or you can cancel.

When the recipients log on to the system, they will see the message in the Reminder Center. Once they read the message, the recipient can follow the same procedure to forward if needed. In this way, all users of this system can exchange practice information with each other.

Now we’ll move forward to the next menu group of Patient/Client.

Patient/Client

The Patient/Client menu group contains the various modules that relate to individual patients. We’ll review the dropdown one at a time.

The first menu item of Patient/Client is Finder.

Finder

The Patient Finder is a Search tool with customizable column headings which are Search terms.

We’ll work with Frank Smith as our current patient, and search for him by last name.

The patient’s identifying information name is listed below the menu on the top left. First is the patient’s name and Patient ID number. Underneath is the patient’s date of birth and age.

To the top right of the screen is the patient’s encounter or visit list search. From this dropdown, you can review the encounter of your choice.

The next menu item is Add New/Search.

Add New/Search

This module is used to add a new patient to the system. By clicking on the checkbox, you can control which demographics you are adding to the patient’s information record. You can also click on the Search button and look for a patient in the system.

We’ll begin with the Face Sheet.

Face Sheet

The Face Sheet holds the patient’s identifying information. As you can see by the red text, Name, DOB and Sex are required fields. Fill in the rest of the information as you can. The other fields may not be required, but can be useful. Notice the checkboxes from the previous screen are at the bottom.

We’ll add a new patient, Jenny Johnson. The red boxes are showing that we still need to add a last name and date of birth.

The completed Face Sheet holds personal information about the patient.

Now we can add the patient’s main contact information by checking on the Contacts checkbox at the bottom of the screen.

Contacts

When you check the Contacts checkbox, it will open underneath the Face Screen. This is where you will add additional information including the emergency contact.

The next checkbox will open the Privacy module.

Privacy

The Privacy module will let the staff know the patient’s preference for sharing her health information.

The next checkbox is Employer.

Employer

This screen will be about the patient’s employment information. Some industries require additional physical or drug screening. Our new patient is a sales executive for an engineering firm.

The next checkbox is for Social Statistics.

Social Statistics

The Social Statistics section prepares the staff for interaction with the patient.

The staff will be aware if an interpreter is needed to speak with the patient or if the patient has religious beliefs that may conflict with a proposed treatment plan.

The financial information is used if the patient is receiving benefits that may need to be followed-up with social workers.

The next checkbox will open the Insurance module.

Insurance

The Insurance module addresses the primary, secondary and tertiary health insurance of the patient. Not all patients have more than a primary carrier.

Now that all of the new patient’s information has been entered, click on the Create New Patient button.

A new screen will open and tell you if there is a matching patient inside the system. We actually want to see there is no match so we are not duplicating our input.

Then we can click on the Confirm Create New Patient button.

This will take us out of the Add New/Search menu item and will open up the Summary screen, which is the next menu item that we’ll explore.

Summary

The Patient Summary screen shows details of the patient’s information that is in the system.

This Patient Summary screen shows that Jenny Johnson is indeed a patient in the system and has all the Demographics information that we have just entered. You can navigate through this module by expanding or collapsing the tabs.

The next menu item is Visits.

Visits

The Visits menu item works the same as the Patient’s Encounter information at the top of the screen. Because Create Visit and New Encounter both open the same New Encounter Form, you can choose your preferred method to open it.

If you have chosen an Encounter then you can see the most recent or review a previous Encounter Form.

If you choose to Visit History then you see the will Past Encounters and Documents form.

The next menu item is Records.

Records

The Records menu item tracks each Patient Record Request from outside resources.

The next menu item is Visit Forms.

Visit Forms

Visit Forms will add a clinical form to the documents of an Open Encounter.

The final menu item of the Patient/Client menu group is Import.

Import

Import lets you add a new patient to the database by an external data transfer.

Now that we have studied the Patient/Client menu group, let’s turn our attention to the Fees menu group.

Fees

The Fees menu group is where the various financial items are found.

The first menu item of Fees menu group is the Fee Sheet.

Fee Sheet

The Fee Sheet is the document where the diagnosis and services rendered for the current visit are recorded.

Payment

The Payment screen is where you accept payment for the patient’s account.

Checkout

Use this module to take a payment and print a receipt of just visit. This option is best suited for cash based practices.

Billing

The Billing Manager is where Accounts Receivables are processed, paper claimed documents can be printed and X12 Images generated for electronic billing.

The next menu item is Posting.

Posting

The EOB Posting screen is where individual End of Business day payments are logged.

Batch Payments

The Batch Payment Entry screen is for entering batch Electronic Funds Transfers (EFT) and Electronic Remittance Advice (ERA).

Verifying Patient Billing Data

The Pre-billing Issues Report assures that all patient contact and insurance information are in the system. You will be flagged if a patient is missing any of this important information.

EDI History

This screen allows you to follow the history of the Electronic Data Interchange that is created during the Fees menu activities.

Now that we understand the Fees menu group we’ll move on to the Procedures.

Procedures

The Procedures is the access point to the modules that order diagnostic procedures and manage the results. LibreHealth EHR does not come with them pre-configured because many practices manage them externally.

The next menu group is Administration.

Administration

The Administration menu group contains the main system configuration modules for LibreHeatlh EHR. Very few of these items can be accessed by any user except an Administrator. Actual use of the menu and sub-menu items are covered in other tutorials of the specific modules.

We’ll take a brief glimpse at a few of the Administration menu items beginning with Globals.

Globals

The Global Settings screen contains the system configuration settings. These are the Default settings for the screen formats and module behaviors.

Edit Menu

The Site Menu Editor is the tool to modify the main menu.

Facilities

Enter the information about the facilities that this LibreHealth EHR supports.

Users

Manage the user profiles of those who are authorized to use this EHR.

Addr Book

The Address Book contains the contact information for all providers, external agencies and other professionals that this facility interacts with.

Practice

The Practice Settings is where you register the pharmacies, insurance companies and clearinghouses that this practice interacts with. You can also configure the Document Storage Repository structure.

Codes

This screen lets you create custom service codes to enhance service code entry into the Fee Sheet.

Layouts, Lists, ACL, Images and Backup

These modules are responsible for deep system administration functions.

Rules, Alerts and Patient Reminders

These modules apply to the Patient Reminders and Clinical Rules functionality.

Other

This module has more system maintenance and control items.

Tags, Patient Tags and Filters

Are all part of the Record Tagging and Filtering system that helps organize patient records in customized groupings.

Now that we’ve explored Administration, let look at the Reports menu item.

Reports

The Reports module contains pre-made practice and patient reports.

Miscellaneous

This module contains items normally don’t fit elsewhere. You will find a lot of the other menu items duplicated in this menu group.

Popups

The Popups module is a collection of one-click access to different forms and documents.

QA Measures

The QA Measures module contains quality assurance activities.

The final menu group is Help.

Help

The About LibreHealth EHR will show buttons that link to to different areas of assistance.

You will see the version number that we first noticed on the Login screen. This is useful in asking for technical support.

The User Manual button will link to this User Guide.

The Online Support button will guide you to the no cost online support forums to consult with the LibreHealth EHR project developers and other users. You can also visit the LibreHealth chat room.

The Acknowledgements, Licensing and Certification button will take you to the various types of information on the LibreHealth EHR project.

Summary

Summary

This concludes the introduction to the LibreHealth EHR system.

We have explored the methods used to Login to the system. We have changed our working environment to our personal preferences. We have also seen many of the tools accessible from the Menu Groups and through the Menu Items.

Stay tuned for more in-depth tutorials on how to do many of the activities available within LibreHealth EHR.

Check out the LibreHealth community inside the LibreHealth Forums.

We hope this User Guide will be of assistance to you as you work with your LibreHealth EHR system.

Contact Author

• Toni Shortsleeve - toni@konikodes.com