The Carry Forward Feature in In Touch EMR

This unique feature allows the users to copy the clinical record, including Subjective, Objective, Flowsheet, Assessment and Plan of Care to another patient record or same patient to a different document. The principle behind this feature is to save the clinician time when working on the documentation so that the information from the previous note automatically appears to the succeeding notes without the clinician having to retype the whole information again. But the clinician will still have the ability to make changes or edits to the documentation to keep it accurate for the current visit. 

 

2 Ways to Carry Forward 

• Inter-Patient/Traditional - this is the default for all documentation. The document takes information from the previous document and copies it to the new document being created 
• Intra-Patient/ Advanced - this allows the users to choose which document or patient to copy the information from. 

 

Inter-Patient/ Traditional Carry Forward

For each new patient, the first document to be created is an Initial evaluation. Once the Initial Evaluation is finalized this becomes the foundation for future note type. That means the information in the Initial Evaluation automatically carries forward or copies to succeeding note like Daily Note 1. Once Daily Note 1 is finalized it will automatically carry forward to the Daily Note 2 and so on. Each document type serves as the carry forward foundation subsequent to the documents of the same type. 

For example:

1. Daily note 2 will carry forward data from daily note 1 (assuming it was right after daily note 1)
2. Daily note 5 has carried forward data from daily note 4 (assuming it was right after daily note 4)
3. Re-evaluation 2 has carried forward data from re-evaluation 1
4. Progress note 3 has carried forward data from progress note 2

...and so on.

Keep in mind, that the daily note always carries forward data from the most recent document of that episode, regardless of the document type.

For example.

SCENARIO 1

1. Daily note 3 was followed by a progress note 1 and the next note is daily note 4.
2. Daily note 4 will carry forward data from progress note 1 and the next note is daily note 5.
3. Daily note 5 will copy data from daily note 4 *

SCENARIO 2

1. Daily note 8 was followed by re-evaluation 3 and the next note is daily note 9.
2. Daily note 9 will carry forward data from re-evaluation 3 and the next note is daily note 10.
3. Daily note 10 will carry forward data from daily note 9 *

SCENARIO 3

1. Daily note 14 was followed by progress note 4. The next note happens to be the third re-evaluation.
2. Progress note 4 was followed by re-evaluation 3. The next note is daily note 15.
2. Daily note 15 will now carry forward data from re-evaluation 3. *

In all situations, the daily note carries forward data from the most recent document of that episode, regardless of the document type.

The discharge note is an exception to this rule.

When a discharge note is created, it will carry forward data from the most recent document of that episode, regardless of the document type.

IMPORTANT NOTE: When the users change the templates (in the Subjective and Objective) it will remove the carry forwarded information. Since the questions in the previous template are different from the newly selected template, it erases all previous answers. 

The system will only automatically carry forward using the notes within the same episode. If you wish to use a  note from a different episode as your foundation document, you need to use the Intra Patient/Advanced Carryforward. 

 

Intra Patient/ Advanced Carry Forward 

There are different ways to use Advanced Carry forward. 

• Same Patient - Same Episode - If users do not want to follow the traditional patterns of carrying forward and wants to dictate manually which finalized document will be the foundation data for the new document, they can choose this way of carrying forward.  Within the documentation section, there is an area at the top that has a Carry Forward From drop-down box. It will list all previous finalized documentation within the same Episode that the user can choose and then click the Carry Forward button. This will automatically show all the entries on the documentation selected to the current document in progress. 

 

• Carry Forward To - Indicated by this icon .  There are several areas where this feature will be available to the users. 
• Within the documentation section - users will see the carry forward to icon  within the documentation section next to the carry forward from drop-down.

 

 

Once clicked, this icon shows a pop-up box that asks the users to select between patient locator or episode locator. 

 

If the patient locator is clicked, it will show a patient locator for the user to type a patient name and select the patient where the document will be carried forward to. After selecting a patient click on Get Episodes. Select the episode that you wish for this new document to appear in.

If the Episode Locator was selected, the user will need to type the name of the episode and the system will look for all patients with an existing episode name. The user can then choose which patient from the list he wants to document. 

After clicking the Carry Forward Note button, it will automatically open a new document under the patient selected and all the information that was on the document in progress will appear on this new note.  

 

• In the patient dashboard - under the document in progress and completed documents, you will see the carry forward icon . This function the same way as stated above where the Carry Forward To pop up will show an option to select a patient. 

 

• Initial Eval Carry Forward From - whenever creating a new Initial Evaluation, you will be provided this pop-up. This allows users to copy data from either of the following options:  

NOTE: For patients without any existing documentation, the first 2 option will be grayed out and not available. 

• Copy Initial Evaluation from the current default episode - This will pull all the data from the very first initial evaluation that was made for the patient.
• Copy Data from an Existing Episode - this allows users to choose which episode he wants to copy the Initial Eval from 
• New Initial Evaluation - when selected, this means no pre-populated information will appear on the documentation. It will be a blank Initial Evaluation form. 
• Copy Initial Evaluation from an existing episode of another patient - when selected this will provide a pop up that will allow the user to select the patient from which the document will be carried forward from and which episode.