Birth History

Field	Description
Detailed document	Provides all details from the templates in the Intake Note or Master document.
Reviewed	Indicates that the documented pregnancy and birth history information of a baby is reviewed.
History unobtainable	Indicates that certain pregnancy or birth history information cannot be obtained.
Last detailed doc date	Automatically filled with the current date when the Reviewed option is selected.
Comments	You can enter additional comments on maternal health and baby's health.

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Recording Patient Details in the Intake Workflow

During check-in, the intake staff can use the Intake template to document a patient details, such as the chief complaint, vital signs, medications, allergies, standing orders, and various other findings. Panel Description General To document the patient's general information. Reason for Visit To document the reasons for the patient's visit. History Summary To document the patient's past medical history, social, medical or surgical, diagnostic study, and family histories. Note: The History Summary section displays the patient history documented on the Histories template . Vital Signs To document and manage the patient's vital signs. Medications To view the patient's current medications and medication history. You can also enter additional prescriptions and reconcile the listed medications with the actual active medications. Allergies To add the patient's known allergies. Orders To view, process, manage, add, edit, remove, and place follow-up orders for the patient. Review of Systems You

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Overview of the Histories Template

You can add, update, delete, and review a patient's history summary details. You can document a patient's social history, problem list, medical or surgical history, diagnostic study history, and family history on the Histories template. Patient's Problem List You can manage a patient's problems. Patient's Medical History The Medical/Surgical/Interim panel allows you to document the medical or surgical history of the patient. Patient's Social History You can document a patient's social history. Patient's Family History You can document the family history of the patient in the Family panel on the Histories template. Patient's Diagnostic Tests and Results You can document a patient's diagnostic tests and the associated results. Document the History Review You can document the review details of a patient's history in the generated encounter document. Intake Note Generation You can generate Intake notes on the Intake template after all the intake activities are complete. View a Patient's Ap

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Histories Template

You can add, update, delete, and review a patient's history summary details. The Histories template enables you to document a patient's social history, problem list, medical or surgical history, diagnostic study history, and family history. You can also add skin cancer details. Documenting a Patient's History Summary You can add, update, delete, and review a patient's history summary details from the History Summary panel. Patient's Problem list Patient's Diagnostic Tests and Results You can document a patient's diagnostic tests and the associated results. Generate the Intake Note You can generate the intake note for a patient using Generate Intake Note in theIntake and Histories template. Document the History Review You can document the review details of a patient's history in the generated encounter document. Parent topic: Intake Staff Workflow

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Intake Template

The intake staff uses the Intake template to document a patient's chief complaint, vital signs, medications, allergies, standing orders, and various other findings that may not have already been recorded on the Home Page - ORT template. Document General Information of Patients You can document a patient's general information on the Intake template. Document Interpreter Details You can document the answers for the pre-configured questions. Document Configurable Questionnaires You can document the answers for the pre-configured questions on the Additional Visit Information template. Patient's Reason for Visit You can document a patient's reasons for visit. Patient's History Summary You can add, update, delete, and review a patient's history summary details from the History Summary panel. Patient Vital Signs You can document and manage a patient's vital signs. Medications You can document and manage the medication history and current medications of a patient. Allergies You can manage pati

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Document Basic Antenatal Details

You can provide the basic details of maternal health in the Antenatal section on the Pregnancy/Birth History template. Open NextGen® Enterprise EHR. On the Intake template, click the Birth History link.The Pregnancy/Birth History template opens. To enter the mother's age, in the Antenatal section, click Maternal age. To enter the estimated date of delivery, click EDC. Click Marital status, and select the status from the Marital Status: Mother list. Select the Lives with FOB option. To enter the obstetric history, click the Gravida, Para, Ab, and Living fields. Select the Prenatal Care given option. Click Maternal blood type, and select the mother's blood type from the list. Select the Rh factor option. Select the Ultrasound results option.If you select Abnormal, the Ultrasound Results list appears, from which you can select the abnormality found in the ultrasound scan. Document Antenatal Screening Tests You can provide maternal health information, such as screening tests, illnesses, in

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Obstetrics Intake Staff Workflow

You can document the intake information in the Intake template. The intake staff workflow for an Initial Prenatal visit involves documenting the patient encounter on the Intake, Gestational Age, Histories, and Education templates. The information documented by the intake staff is reviewed by the provider. When you open the Intake template, select Obstetrics and OB Prenatal Initial from the Specialty and Visit Type fields to display the Initial Prenatal template set. The Intake template includes various links to add more information about the patient. Review of Obstetrics Details by Intake Staff The intake staff can review the patient's details documented during the previous encounters. Viewing Links on the Intake Template The links on the Intake template allows you to open the templates where you can document the patient details. Zika Pregnancy Screening Template You can use the Zika Pregnancy Screening template to check the patient or patient's partner for possible exposure to Zika. P

Birth History

Recommendations

Recording Patient Details in the Intake Workflow

Overview of the Histories Template

Histories Template

Intake Template

Document Basic Antenatal Details

Obstetrics Intake Staff Workflow

Birth History

Recording Patient Details in the Intake Workflow

Overview of the Histories Template

Histories Template

Intake Template

Document Basic Antenatal Details

Obstetrics Intake Staff Workflow