Log In and Activate Availability
Enter your username and password to access the practice's Vision(X) site:
After logging in successfully, select the intended organization and location. Next, click your nameplate icon near the upper-right hand side of the screen, then use the provided toggle to set your profile as "Available." Remote providers who are not in "available" status are ineligible to conduct patient exams in Vision(X):
Select the Patient and Activate Exam
In order to conduct an exam, the patient needs to be checked-in. Today's patients can be viewed in the scheduler tab, or by viewing the provider worklist in the EHR. Use the search fields to narrow your worklist to the appropriate patient, select the patient, then click "Go to Chart" to review existing data from previously saved exams, or click "Start Exam" to begin the scheduled exam:
From "Today's Patients" list, adjust the patient's appointment status, then click "Check In":
Continue through Patient Details, Appointment Details, and Attachments & Notes menus to confirm/adjust information as necessary, then click "Complete Check-In.' You will receive a message confirming that the patient is checked-in:
Review Patient Chart and Past Encounters
The patient is now listed in the "Checked-In Patients" grouping. Click "Go to chart" to view the patient's chart details:
Patient information from prior saved exams can be viewed by opening any field, then selecting the "View and Pull forward from previous encounters":
The option to View and Pull forward data from previous encounters is also available when viewing the patient's chart by clicking the pull-out tab from the right-hands side of the screen:
The exam template will populate, and green dots in the threaded patient and exam sub-tabs indicate indicate that the exam is underway. Users can use drop-down arrows to collapse/open information categories, and use the drop-down exam status menu to make adjustments mid-exam as necessary. To document information categories for this exam, select the pop-out arrow for any field:
To access prior saved exam information relevant to each portion of the exam, click "View & Pull from other encounters":
The Encounter Search menu will open with all recorded info for this category as saved from previous exams. Use the provided search fields or simply scroll through prior history to find the relevant past exam. Click "View Encounter" to view the complete chart from that past exam, or select the check box and click "Pull forward selected" to import saved data to the current exam:
Documenting External & Internal View
External (slit lamp) and internal (retinal imaging) documentations are required in order to complete a remote care exam. Slit lamp videos can be reviewed and documented from the Ocular Health section in the Anterior Segment fields. Videos can be viewed by opening the clinical images module:
Retinal images can be reviewed and documented from the Ocular Health section in the Visual Pathway fields. Open the Clinical Images Module and select RI PACS to review the images from the software:
Connecting Remote Provider to Patient
Upon the completion of pre-testing, the local technician will select a button labeled "Assign to doctor". This adds the patient to a queue consisting of any doctor who is both marked as "Available" via the toggle in the Patient List screen and also affiliated with the location at which this patient is being seen.
When the patient's queue position is matched with an available doctor, that doctor will hear an audible sound and receive a connection request message on their screen. Click "Connect with patient" to associate to the exam.
NOTE: This action only associates the doctor with the exam, and does not instantly launch a connection window directly to the patient.
If the remote provider does not select "Connect with patient" within 1 minute, the system will attempt to connect the patient with the next available and eligible remote provider. If there are not other providers available and the doctor does not select "Connect with patient" within 5 minutes, the patient's status will update to "Waiting Room."
Before connecting with the patient, be sure to verify that your web browser settings are configured for all necessary devices (webcam, microphone) to be enabled:
Completing Documentations as Remote Provider
With the audio/video connection now live, the remote provider is free to interact with the patient. The local technician can serve to make a direct introduction between provider and patient, reiterate why the patient is being seen, and update the doctor with any information that might not yet have been documented in the medical record.
Additional controls for documenting various exam fields utilizing integrated optical device readings are available for remote providers.
Once all prescription information has been documented, the provider may click "Sign Rx draft" if appropriate:
The provider's consultation with the patient can be ended by either closing the video conferencing interface, or by signing the Rx draft. After disconnection from the patient, the provider remains connected to the exam chart, and can continue making various documentations as necessary. Once the exam is finished, click "Sign chart":
The Remote Provider's examination is now complete:
