Note

A medical note, or electronic medical note, contains all relavent, free form information as it pertains to an encounter between a medical provider and patient.

The Note module of TouchWorks Version 11 replaces the note definitions of Version 10 with note templates. The appropriate sections, text templates, note forms, lists and results can be configured to automatically populate the note based on how the note template is configured. Note functionality is managed from the Note Admin workspace.

The concepts of Version 11 Note are described below.

DOCUMENT TYPE

• Term used in administrative workspaces

• Created in Document Type Dictionary (TW Set Up)

• Links to: Note input & output templates

• Used when defining auto-print defaults

• Displayed in ChartViewer on Clinical Desktop as labels for output documents generated by Note module

NOTE INPUT TEMPLATE

• Term used in administrative workspaces

• Determines contents that are displayed in NAW

• Each is linked to a document type