Doing a Full Consultation in Inca Clinic

This pages explains each of the steps that can be included in a Care Pathway. A brief explanation is given for each step, and a pointer is given to more information (there is a separate page of documentation for each step).

A Care Pathway is a sequence of these steps; and you run a chosen Care Pathway to run a consultation with a patient.

Remember that not all consultations include all of the available steps. For example:

  • Only travel clinics are likely to include the Travel Itinerary step in a Care Pathway.
  • You may have a first medic run a consultation to record a patient's medical history and choose the appropriate vaccines; and a have a second medic run a consultation to administer the chosen vaccines. The second consultation can be set up to “follow on” from the first.

Care Pathways are a great way for you to configure Inca Clinic to your needs. The system comes with a set of pre-configured Care Pathways, and you can modify these and/or create your own.

The full list of steps

Inca Clinic supports the following steps, any of which can be added to a Care Pathway:

Name Section of this document Link to the full documentation page
Travel Itinerary (relevant only to travel clinics) here here
Medical History here here
Vaccination History here here
Vaccine Scheduler here here
Vaccine Administration here here
Prescriptions here here
Laboratory Orders here here
Consultation Summary here here

Progress

While you are running a consultation, the set of steps for the chosen Care Pathway is shown along the top of each page. The current step is shown in blue; previous steps are shown in green.

How to Start and Finish a Consultation

Once a patient is registered in Inca Clinic (see find a patient, or create a new one), you can start a consultation by either

  • clicking the Start Consultation button on the Patient Record screen, or
  • by first adding the patient to the Waiting Room and then pressing the Start Consultation button opposite the patient's name on the Waiting Room screen.

In the first case above, the patient will be automatically added to the Waiting Room. The system allows a patient to be explicitly added to the Waiting Room because non-medics cannot run consultations.

Finishing or Canceling a Consultation

The Finish Consultation button allows you to finish a consultation at any stage.

The Cancel Consultation button allows you to cancel the consultation, but please note that some of the work done will have already been saved and will not be automatically undone if you cancel (when you press the cancel button, Inca Clinic presents a list of what is saved and what is not).

Options during the consultation

On any step of a consultation, you can view basic information for the patient (address, date of birth, etc) by clicking on the patient's name at the top of the page. (You can dismiss this information by clicking again on the patient's name.) You can edit these details by clicking the 'Edit Patient Details' link which appears.

 Edit Patient Details

To add medical notes, click the 'Consultation Notes and Summary' link.

 Add Consultation Note

Medical Notes from previous consultations are available by clicking the 'See All Patient Notes' link which appears.

A Quick Look At Each Step

Most of the remainder of this page gives a quick look at each of the types of steps that Inca Clinic supports.

Consultation Step: Travel Itinerary

This is the Travel Itinerary screen, which of course is relevant only to travel clinics. (More details on this step are provided on the Travel Itinerary documentation page)

Travel Itinerary step in the consultation

A start date can be given (or the Unknown Duration box can be ticked). Each destination is added by typing in the name of the country (once you type a few letters, a list appears with matching country names), followed in the same input box by the duration. The duration can be a number of days, weeks or months.

For a travel clinic, it's important to add itinerary details, as this can change the set of vaccines brought to your attention in later screens. In the example shown here, Hotel and Holiday are chosen. At a minimum, you should select one from the Accommodation list and one from the Purpose list. By using the Common Itinerary Details box, you are stating that these details apply to all of the countries in the itinerary. Alternatively, you can input a different set of details for each country, by first clicking on the spanner icon to the right of each country name.

When you are finished, press the Save button. Then press the next step in the itinerary.

Consultation Step: Medical History

This is the Medical History screen (more details on this step are provided on the Medical History documentation page):

An overview of recording the patient's medical history

The patient's medical conditions are shown on the left-hand side. You can add to this list by either:

  • clicking on one of the blue buttons. There is a button for each “common” condition (the Medical Director can create or delete medical conditions, and decide which are marked as common (so that they are available as a button on this screen).
  • typing in the name of a medical condition (once you start typing a few letters, the system shows a list of matching medical conditions).

Remember that not all medical conditions are shown as buttons. However, it would be usual for each clinic to ensure that the medical conditions that they most commonly record (for example, those that appear on their patient registration card) are marked as common.

As with most configuration chores, Incaplex can help you make the changes to the system that you require: you can decide what you want, we can make the changes on your behalf, and you can check that the system is then sep up correctly.

Consultation Step: Vaccination History

This is the Vaccination History screen (more details on this step are provided on the Vaccination History documentation page):

Vaccination History

There are two parts to this screen:

  • Vaccine Cover Graph: the top part shows the vaccines in a graph. The colour of each bar indicates its status (and the statuses are explained in the panel to the right).
    • Only for Completed vaccines the length of the bar indicates the cover provided.
    • For In Progress (Scheduled) vaccines (shown in blue), the bar indicates the cover that will be provided when the vaccine administration is completed.
    • You can get more information by hovering the mouse over each bar.
    • By default, Cancelled and Incomplete vaccines are not shown. You can see them using the Display setting button.
  • Vaccine Cover Table: the bottom part displays the information displayed on the Cover Graph but in a tabular format.
    • The 'Add Vaccine' feature is intended only to record historical vaccines, including vaccines that you may have been administered during an off-site visit to a company, school or college. It is important that you do not overuse the Add Vaccine feature: you should use Inca Clinic's Vaccine Scheduler whenever possible.

Consultation Step: Vaccine Scheduler

This is the Vaccine Scheduler screen (more details on this step are provided on the Vaccine Scheduler documentation page):

Vaccine Scheduler overview

This is a key screen during a consultation, in which the medic chooses the vaccines for the patient. The list of vaccines is shown on the left-hand side. Those selected are shown to the right.

  • Each of the 4 selected vaccine shown here has had a schedule chosen for it. Sometimes there is just one schedule for a vaccine, but some vaccines have a number of schedules for you to choose between. The Medical Director can add and remove schedules for any vaccines (and of course add and remove vaccines).
    • The screen shows that Stamaril has just been added (there are two schedules shown for it). The Primary one has been selected.
  • It is also possible to mark a vaccine as Discussed, Declined or Contraindicated.

The list on the left is actually in two lists:

  • Vaccines to be Considered: These are vaccines that may be of particular relevance for the patient's trip. The list shown depends on the countries and also the behaviours (accommodation, purpose and activities); but also on how the Medical Director has configured the system (he or she decides on which diseases are at risk in each country, and also which vaccines should be used in most cases).
    • The “vaccines to be considered” are shown at different risk levels. The risk levels in blue may be of particular interest; those shown in gray may not be of such relevance (probably because the patient is not planning the behaviours that would give rise to those risks).
  • the diseases known to the system are shown below the vaccines; it is easy to select a disease and then a vaccine that covers that disease, and add this to the patient's overall vaccine schedule.

Usually you will use the Vaccines to be Considered list, or whichever part you think is appropriate; and then add cover for any diseases that you also want to provide cover for. You could discuss with your Medical Director whether or not the system's configuration should be changed to add such manually added disease(s) into the Vaccines to be Considered list.

The medic should make his or her decision on which diseases the patient is likely to be exposed to and which vaccines are appropriate, and not rely on any automated system.

The medic can change the dates, and even the number of doses for each vaccine this patient should receive (see the Vaccine Scheduler documentation page).

The medic must use the Validate button before saving the patient's schedule. This lists any warnings that the system is aware of. The system does not prevent you from making your choice but it may present some warnings that you might want to be aware of.

Consultation Step: Vaccine Administration

This is the Vaccine Administration screen (more details on this step are provided on the Vaccine Administration documentation page):

Vaccine Administrator overview

The vaccines to be administered today are shown on the left-hand side. The batch number for each vaccine must be selected from its drop-down list or a new batch number must be entered.

If you hover the mouse over a body site, the button Add all vaccines will appear. Clicking this will add all of the vaccines to this site. Alternative ways of adding vaccines are shown on the Vaccine Administration documentation page.

Date-related advisories and warnings may be shown at the top.

Finally, you should press the Confirm Administration button after you have administered the vaccines. If you need to change any details, you should do so before pressing this button.

Consultation Step: Prescriptions

This is the Prescriptions screen (more details on this step are provided on the Prescriptions documentation page):

Prescriptions overview

This screen allows you to add prescriptions to the patient's script. The medications are shown on the left-hand side, divided into a number of categories. The screen here shows the Common Medications list expanded to show individual choices.

Instead of selecting medications from the left-hand side list, you can type the name of the medication (once you type a few characters, the list of matching medications will be shown).

Consultation Step: Laboratory Orders

This is the Laboratory Orders screen (more details on this step are provided on the Laboratory Orders documentation page):

Laboratory Orders overview

You can select a laboratory order using one of the blue buttons, or you can type the name of the laboratory order (once you type a few characters, a list of matches will be shown). The Medical Director can manage the list of common laboratory orders, i.e., those that are shown as buttons.

Chosen laboratory orders are shown on the left-hand side.

Consultation Summary

Once the consultation has been finished, the Consultation Summary screen is shown. More details on this step are provided on the Consultation Summary documentation page.

Running a Consultation in Data Entry Mode

There may be times when you need to enter the details of a consultation a day or two after it actually took place. Inca Clinic allows you enter a consultation retrospectively and even record that information on behalf to the medic that performed the actual consultation.

NOTE: To run a consultation in Data Entry Mode you must have permission to run a consultation.

To start a consultation in Data Entry mode, open the Patient Record and click 'Start Consultation'. (You cannot use the Waiting Room to start a Consultation in Data Entry mode.)

Once the Care Pathway selection page appears, click on the 'Data Entry Mode' link at the top of the page, choose the person (the medic) that you are conducting the consultation for (this can be yourself, of course) and select the date on which the consultation was conducted. Finally, choose the Care Pathway as normal.

 Data Entry Mode

NOTES

  1. Enter the information as for a normal consultation, except for the Vaccine Scheduler and Vaccine Administration steps.
  2. Use the Past Vaccine History step to enter the details of the vaccines given. (In particular, read the documentation on adding Vaccines in Progress.)
  3. If you use the normal Vaccine Administration step to record vaccines already given in the past it will use today's date as the date of administration, which is likely not to be want you want!
  4. It's good practice to create a Care Pathway with a name such as 'Data Entry Consultation' which contains the consultation steps you need. This makes it easy to identify data-entry consultations.
  5. Inca Clinic records the name of the medic who conducted the actual consultation, in the data field called Consulting Medic.

LIMITATIONS

  1. Using the Past Vaccines feature does not allow Batch Numbers to be recorded. This is scheduled for a later release.

Invoicing

This is the Invoicing screen. More details on this step are provided on the Invoicing documentation page.

More Information

full_consultation.txt · Last modified: 2017/01/02 12:36 by sean
 
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