How do I use flowsheets?

Practice Fusion’s customizable flowsheets can help you improve patient progress by allowing you to track all relevant vitals and lab results in one location. With flowsheets, you have the ability to:

  • Add multiple vitals to a single encounter
  • Review and edit vitals from previous encounters
  • Enter additional properties for vitals, such as blood pressure measurement location and patient position
  • Review multiple lab results simultaneously
Click the link below to view each section:
Exploring flowsheets

Copying community flowsheets

Creating a flowsheet

Adding a header

Adding a vital

Adding a lab observation

Editing a flowsheet

Setting defaults on a flowsheet

Adding flowsheets to a patient chart

Deleting a flowsheet

Frequently Asked Questions


Exploring flowsheets

By default, all patients have a Vitals flowsheet.  From the Summary tab of the patient chart, you will see the Flowsheets section containing the default “Vitals” flowsheet.




Clicking on the Vitals flowsheet will open the flowsheet in a separate tab.

Adding Flowsheet values

There are three options for adding or editing flowsheet data.


Option 1: Click on any blue value or any blank cell where the header is blue. Blue text indicates that the value can be edited. For vitals, this means that the encounter has not yet been signed.  For lab results, this means that the result was manually entered using the “Enter Lab Results” option from the Actions menu, and that the result has not yet been signed.  


When clicking on a cell, you will be able to edit the vital or lab value, view additional details, and quickly access the source (either the Encounter or the Lab Result).


Option 2:  Click on the date in the header of a column.

This allows you to edit all of the items in that column.  You can press the tab key on your keyboard to navigate between the fields.  To change the date/time for the column or enter comments for it, click the date/time in the header again.

Option 3: Add a new column of data to the flowsheet.  You can do this by:

  • Clicking the  Add Column button

         

  • Clicking the + icon

          
  • Clicking into any cell within the empty column on the far right

          


With each option,  the system  will first ask if you would like to create a new encounter or add to an existing one.


Once you have added a new column, you can add and edit values using the same steps as if you were editing an existing column (outlined above).


Copying community flowsheets

The fastest way to get started with flowsheets, in addition to using the default "Vitals" flowsheet, is to copy a flowsheet from the Community.  For now, only flowsheets published by Practice Fusion are available in the Community.  In the future, the Community  may support flowsheets published by Practice Fusion providers, similar to how you can publish charting templates.


1. Click Settings in the top-right corner and select Flowsheets (under the Charting header).


2. Select the Community tab.



3. Select a flowsheet that interests you to view additional information.

4. Click the Save Copy button. You will then be able to rename and customize the flowsheet.



Creating a flowsheet 
To use flowsheets, you’ll first need to set up one or more flowsheets for your practice.

1. Click Settings in the top-right corner and select Flowsheets (under the Charting section)


2. The Your practice tab lists all flowsheets that have been created for your practice. Click Create flowsheet to build a new flowsheet.
Note: The ‘Community’ tab will allow you to search the Practice Fusion flowsheet library


3. Start by entering the name of your flowsheet within the Details field. 
Note: The specialty listed in your User Profile will automatically populate in the 'Details' field. You may add an additional specialty if applicable.


4. You may then add Headers, Vitals or Lab tests.

Adding a header
A header breaks up the flowsheet so that you can easily read the data and group similar items. You can also collapse and expand sections of the flowsheet.

1. Click 
Header to name the row, then click Save.


Adding a vital
1. To add a vital to a flowsheet click Vital


2. You may then select a vital from the drop-down list or begin typing to search for a vital. Once you’ve selected your vital, click Save. 
Note: There is not a way to add custom vitals at this time
FS_2png
3. You can add additional rows by continuing to click Vitals.

Adding a lab observation 
To add an observation to a flowsheet, click 
Observation. Begin typing to search, then select an observation from the drop-down list. 


Alternatively, you can click Test/Panel/Study. Begin typing to search for and select the test by name. 


You can then select the observations you’d like to add and click Add observations. Those observations will be added to your flowsheet.


Editing a flowsheet 
When editing a flowsheet template in
either the EHR Settings or patient chart, you can:
  • Rename a flowsheet by clicking Rename or updating the Name field.

  • Move individual rows up or down by clicking the “grabber" icon on the left and dragging the row.fs_3png
  • Edit a row by clicking the pencil icon or remove a row using the X button

  • Click the blue Header, Vital, Observation or Test/Panel/Study links to add a new row.


Once you’ve finished editing your template, click Save for this patient.

Setting defaults on a flowsheet

Once you have added headers, vitals, and labs to your flowsheet, you can choose how the flowsheet will be applied to your patients' charts.


When editing a flowsheet, the Apply Flowsheet section towards the bottom will determine where the flowsheet will be automatically be shown.


By default, all new flowsheets are set to the first option, which allows you to manually add the flowsheet to any patient chart.  This option is used for flowsheets that you only want to apply to individual patients.


The second option allows you to apply the flowsheet to patients associated with certain providers.  This will apply the flowsheet to all of the selected provider's patients, where that provider is listed as the “Preferred Provider” in the Care Team section of the patient's Profile.


The last option will apply the flowsheet to all patients in your practice.  The default "Vitals" flowsheet mentioned at the beginning of this article utilizes this setting. When choosing this third option, an alert will notify you of the change.


Similarly, if you change a flowsheet from being defaulted for all patients (option 3) to being available only when manually added to a chart (option 1), an alert will notify you that the flowsheet will be removed from all patients in your practice unless you have already manually attached the flowsheet to a patient's chart.


Once you’ve finished editing your template, click Save for this patient. If you are editing it from the Settings section, click Save.


Adding flowsheets to a patient chart 
You can add a flowsheet to a patient chart in two locations

  • The Summary tab
  • Within an encounter
From the Summary tab: 
1. Click the pencil icon, located to the right of Flowsheets. Select a flowsheet from the drop-down or begin typing to search for a flowsheet. Select the flowsheet name to add it to the chart. 


2. Click the search box again to continue adding flowsheets to the patient chart.

3. Click on a flowsheet name to open and edit it in a new tab.


4. You can also reorder your flowsheet list by clicking Edit, then Move up or Move down.


Within the Encounter:
1. Scroll down to the Flowsheets section and click Edit.


2. Begin typing to search for a flowsheet in your account and select the flowsheet name to add to the patient chart.  You may also click Edit to:
  • Create a new patient or practice flowsheet
  • Reorder your flowsheets, using the Move up or Move down buttons 


3. Once you’ve finished attaching your flowsheets, click Done.

Deleting a flowsheet
  • To delete a flowsheet from the Summary tab, click the X.  
  • To delete a flowsheet within an Encounter, click Edit (located to the right of that specific flowsheet), then Delete.
A confirmation that the flowsheet will be removed from the patient chart will display.
Note: This does not actually delete any data, just the flowsheet itself.


Frequently Asked Questions

Will lab values auto-populate, or will those need to be manually entered?
Your lab values will auto populate as long as you’re connected to one of our  300+ lab partners.  If any lab values are not auto-populating, this may be due to the lab observations selected for your flowhseet. For detailed instructions on how to resolve this, see: How do I choose the right lab observation for my flowsheet?

If you're not connected to a lab partner, you can add those values manually.  Values will then populate when lab flowsheets are added. For more information on connecting with one of our integrated lab partners, see How do I sign up for a lab integration?

Can we add custom vitals or variables?
Not at this time; however, our team will be collecting feedback from customers to prioritize which variables we’ll be adding next.

Can we have the current date listed first? (ie: display in descending order)
Based on our user research sessions, our customers preferred ascending order. However, if the current order is hindering your workflow, please let us know.

Could you limit the number of days that are displayed on the flowsheet?
Yes, it is possible for us to limit the number of days displayed. For example, we’ve considered limiting it to 5 days for patients with frequent appointments, but we’ll be relying on your feedback to help us decide on the best time-frame.

Can flowsheet values be alphabetized?
Yes, you may move a particular flowsheet up or down in the list using the Move up or Move down buttons.

Is is possible to assign flowsheets to specific types of patients?
At this time, you can apply flowsheets to all patients or assign flowsheets to patients associated with a particular provider. However, we’re considering allowing providers to auto-assign flowsheets based on specific demographics or diagnoses in the future.


For more information on flowsheets, please see:

Charting

  1. How do I search for patients in the EHR?
  2. How do I customize my patient chart view?
  3. How do I complete a chart note?
  4. How do I use rich text editing when charting my encounters?
  5. How do I add diagnoses to a patient chart?
  6. How do I add a medication?
  7. How do I use flowsheets?
  8. How can I preview previous encounters and results while completing an encounter?
  9. How do I print a patient's chart or certain sections of the patient's chart?
  10. How do I print a chart note?
  11. How do I add past medical history (PMH), allergies, medications and diagnoses to an encounter?
  12. How to record and print patient demographics and profile
  13. What information is available in a patient's Timeline?
  14. How do I use the growth charts?
  15. How do I merge duplicate charts?
  16. How do I print the care plan?
  17. How do I open an existing patient chart?
  18. Can vitals be added in Metric Units or US Customary Units?
  19. How do I add advanced directives?
  20. How do I add allergies?
  21. How can I edit my signed chart note?
  22. How do I add Family Health History?
  23. What is the difference between a SOAP and Simple note?
  24. What are the Character Limits when Charting?
  25. What are the limits of simultaneous editing?
  26. What are Screenings/Interventions/Assessments?
  27. Where can I learn more about the different components of an encounter?
  28. How do I delete or deactivate a patient?
  29. How do I edit information on the Patient Summary?
  30. How can I view Diagnosis comments?
  31. How do I search for inactive patients?
  32. What are Clinical Decision Support (CDS) advisories?
  33. How do I change the date in an encounter?
  34. How do I populate the list of Frequently prescribed medications?
  35. How do I view more information for medications?
  36. Why am I receiving the error "Unable to sign" when trying to sign a chart note?
  37. How do I delete an unsigned encounter?
  38. Who can sign a chart note?
  39. How do you change the 'Seen by' provider in the new encounter?
  40. How do I add a patient?
  41. What information is required to save a patient's chart?
  42. How do I create a patient record number?
  43. How do I edit an existing SOAP or Simple Note?
  44. How do I record "Unknown Family History?"
  45. How do I pull history from one patient visit to the next?
  46. How do I refresh a patient's chart?
  47. How do I start a new note/encounter in Practice Fusion?
  48. How do I create and export a Continuity of Care (CCD) clinical document?
  49. What is the file size of a patient image?
  50. Can I move a Patient Record Number from one chart to another?
  51. How do I view or update a patient's appointment within their chart?
  52. How do I add a custom medication?
  53. How many charts can be open and how do I close them simultaneously?
  54. How do I assign a Care Team?
  55. How do I add vitals to flowsheets?
  56. How do I customize my template line settings?
  57. How do I set my patient list and Timeline default?
  58. How do I attach a document to an encounter?
  59. How do I create and update "My Dx List"?
  60. How do I add custom allergies?
  61. How do I participate in the Prolia® Safety Program?
  62. How do I document patient risk score?
  63. How do I document an implantable device?
  64. How do I document social history?
  65. How do I add Goals and Health Concerns to the patient Summary?
  66. Why am I seeing CCDA display errors?
  67. How do I manage display settings for inbound CCDAs?
  68. How do I add new Encounter Types?

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