Appraisal for Alcohol or Chemical Substance Use

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Review Reasons for a Patient's Visit

You can review and update reasons for a patient's visit during the provider workflow. Open NextGen® Enterprise EHR. Open the SOAP, and then expand the Reason for Visit panel. Review and update the patient summary in the Introduction field. Review and update reasons for visit, diagnostic studies, and chronic conditions. To add any additional information, select Comments. Review Intake Comments on the SOAP Template Review comments entered during the intake if the Intake Comments link on the SOAP template indicates that content is present. Edit a Reason for Visit on the SOAP Template You can edit existing reasons for visits on the SOAP template. Add and Review Comments for the History of Present Illness You can review and enter additional comments for a patient's history of present illness (HPI). Remove a Studies Reviewed on SOAP Template You can remove the historical diagnostic studies that are added to the history of patient illness in the Studies Reviewed section on the SOAP template.

NextGen Behavioral Health Suite Help 5.5

Document the Patient's Mental Health and Risk Assessment Information

Open NextGen® Enterprise EHR, and then in Patient History, select Open Templates. The Select Template window opens. On the Medical Records tab, select All. From the list, select Comp Assess - BH Hx, and then select OK. To document the patient's medical and surgical details in the Past Medical/Surgical panel, select Add. Note: To document the patient's mental and physical health details, you can select the corresponding links in the Past Medical/Surgical panel. In the Substance Use/Addictive Behavior History panel, document the details about the patient's addiction to substance use. In the Mental Health and Addiction Treatment Service panel, document the patient's treatment details about the mental health and substance use. In the Medication Information panel, review and update the patient's medication details. In the Mental Status Evaluation panel, enter the patient's mental health details. Note: To document the patient's mental health status systematically, you can select the Mental s

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Document Information with Website Screening Tools

You can document information in the screening tools that open as websites using the Screening Tools template. Open NextGen® Enterprise EHR. Select a patient encounter, and open a template. For example, Intake. Select Navigation, and then select Screening Tools. The Screening Tools template opens. To view the screening tools, do one of the following: To view the screening tools configured for the selected specialty, select Current Specialty. To view all the screening tools, select All. Note: When you do not select a specialty for an encounter, the All option is selected by default and all the screening tools appear on the Screening Tools template. In the Screening Tools Available panel, select a screening tool with the W indicator. The associated screening tool website opens. Document details provided by the patient. The selected tool appears in the Screening instrument field. Enter the screening score manually. Select Add. The documented details appear in the Screening Tools Performed

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Document a Patient's Drug Use

You can document the drug use of a patient on the Confidential – Alcohol/Drug template. Open NextGen® Enterprise EHR. To open the Confidential – Alcohol/Drug template, do one of the following: In the Social panel on the Histories template, select the Confidential History link. In the History Summary panel on the Intake template, select the Confidential link. In the Drug Use/Abuse section, indicate the patient's use of drugs. If you select No, no other documentation is required in this section. If you select Yes or Formerly, enter the age at which patient had started using drugs, the drug type, frequency of drug use, and route. If the patient had used the drug earlier and has now quit, select Quit. Indicate if the patient has sought treatment for drug abuse. If you select Yes, enter the number of times the patient is treated and the date of the last treatment. Select Outpatient or Inpatient to indicate the type of treatment. Indicate if the patient is involved in a 12-step program. If y

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Document a Patient's Drug Use

You can document the drug use of a patient on the Confidential – Alcohol/Drug template. Open NextGen® Enterprise EHR. Open the Histories template. In the Social panel, select the Confidential History link. The Confidential - Alcohol/Drug template opens displaying the links to the confidential templates, in the left pane. In the Drug Use/Abuse section, indicate the patient's use of drugs. If you select No, no other documentation is required in this section. If you select Yes or Formerly, enter the age at which patient had started using drugs, the drug type, frequency of drug use, and route. If the patient had used the drug earlier and has now quit, select Quit. Select Yes or No to indicate if the patient has sought treatment for drug abuse. If you select Yes, enter the number of times the patient is treated and the date of the last treatment. Select Outpatient or Inpatient to indicate the type of treatment. Select Yes or No to indicate if the patient is involved in a 12-step program. If

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Document a Patient's Alcohol Use

You can document the alcohol consumption details of a patient on the Confidential – Alcohol/Drug template. Open NextGen® Enterprise EHR. To open the Confidential – Alcohol/Drug template, do one of the following: In the Social panel on the Histories template, select the Confidential History link. In the History Summary panel on the Intake template, select the Confidential link. In the Alcohol Use section, enter the age at which the patient had started drinking alcohol. Indicate if the patient has sought treatment for alcohol abuse. If you select Yes, then do the following: Enter the date of the last treatment for alcohol abuse. Enter the number of treatments taken for alcohol abuse. Indicate if the patient is involved in a 12-step program. If you select Yes, select Currently or Formerly. Indicate if the patient has had withdrawal problems, seizures, or blackouts from alcohol or drugs. Indicate if the patient has required emergency medical attention due to intoxication. If you select Yes

Appraisal for Alcohol or Chemical Substance Use

Recommendations

Review Reasons for a Patient's Visit

Document the Patient's Mental Health and Risk Assessment Information

Document Information with Website Screening Tools

Document a Patient's Drug Use

Document a Patient's Drug Use

Document a Patient's Alcohol Use

Appraisal for Alcohol or Chemical Substance Use

Review Reasons for a Patient's Visit

Document the Patient's Mental Health and Risk Assessment Information

Document Information with Website Screening Tools

Document a Patient's Drug Use

Document a Patient's Drug Use

Document a Patient's Alcohol Use