Clinical Notes

The Clinical Notes facility in PPS is available in the “Professional” version of PPS. This includes areas to record your Clinical Notes, manage Treatment Episodes, complete specific forms (Custom Forms) including body charts, your own questionnaires and so forth. All Clinical Notes are structured into the framework of Treatment Episodes.

Certain practices may use slightly different terminology, but as a basis PPS uses “Treatment Episode” to define a specific course of treatment for a specific condition, and “Consultation” as the individual treatment sessions/consultations. Therefore each time you see a client – whether or not it is an initial consultation/assessment or a follow up treatment – this is known as a “Consultation” and all Consultations will be part of the active Treatment Episode. You can have more than one current Treatment Episode per client if required.

Start-up and Overview

a.    To open up your consultation notes screen, simply click on “Consultation” on your left hand side task bar, or go to your PPS Menu > Client > Consultation.
 


b.    You will need to search for a client firstly


 
c.    And you will then be given the option to click on New for a new consultation, or you will be able to select an existing treatment episode from the list if there are any by highlighting them and then clicking on Select



d. We can see from this example above that the screen is divided into three main areas.

1) The main note-taking area at the top which includes the blue heading bar: Consultation Notes and also includes the various heading and formatting buttons that you can use whilst taking notes.

2) The bottom left half of the screen is a quick preview of all previous consultations which you see by clicking on each one respectively.

3) The bottom right portion of the screen is a formatted preview of past notes. You can see here how this preview includes notes taken using symbols and formatted text (bold headings, etc.).

Also, in the example screen above, the standard headings buttons have been changed to Subjective, Objective, Assessment, Treatment and Plan. You can changes these to your own preference using the PPS menu > Tools > Options > General System Options, Clinical Notes.

Accessing Previous Notes

a.    If you need to access your previous consultation notes from this screen, you can either click on the highlighted heading in the preview section, or you can double click on the heading in the summary section (bottom-left half). This will bring up the selected consultation notes in their own window where you can make changes or view the notes as necessary.

Custom Forms

a.    Custom Forms are accessed by simply using the "Complete a Form" button in the light-blue toolbar near the top of the screen.

b.    Existing Custom Forms are accessed in the same way as accessing previous consultation notes – either click the heading in the preview section, or double-click the heading in the summary section. Further information on custom forms can be found in a separate PPS help guide.

The Consultation Notes Toolbar

a.    Whilst typing your consultation notes, you can use features on the toolbar to assist with the formatting of your note taking. The toolbar is located above the note/taking area.



b.    These toolbar buttons are located in the top right of the consultation note taking area. The buttons are only visible whilst typing in this area. To use the buttons you can either click a button first then type your text or you can highlight existing text and click the button.

c.    The two right-hand buttons will bring up new toolbars – Symbols (denoted by the button with the symbol) and Texts (denoted by the TEXT button).

d.    Once the Symbol or Text toolbars are visible, you can use them to insert from your own collections of Symbols and Standard Text entries as required. Setting up and using your own symbols and text entries are discussed in the next section.



e.    In addition to the formatting toolbar, you can also insert your own headings into the notes. When you click on these buttons, the selected heading is inserted in Bold at the end of your current notes entry. Note that the Date/Time button will insert the current date/time and your initials. This button is customisable from your PPS Menu > Tools > Options > General System Options > Clinical Notes.

Setting up your Symbols and Texts

a.    In order to take advantage of the new Symbols and Texts toolbar features, you must first set these up. Symbols and Text sets are set up using the PPS Menu > Tools >Lookup Tables. Select Symbols and Text Entries from the "Clinical Notes Tables" section.

b.    This will display a new "Symbols and Text Sets" screen. From here you can add new Symbol or Text Sets.



Setting up Symbols

a.    Symbols are contained within “Sets”. This means that you can have as many or few symbols in each set as required. When the Symbols toolbar is used on the consultation screen you can select which Set you want to use from the top of the toolbar. This then displays all symbols included in the set.

b.    From this screen highlight the yellow "Symbol Sets" folder and click the New Symbol Set button.



c.    Enter a name for your symbol set. This will be the name that you select on the symbols toolbar. The description is for your own reference only. As an example, enter "Physio Symbols" in the name. Then click Save.

d.    This will show your new Set in the list under the Symbol Sets folder. You must now add your symbols to your new Set.

e.    To do this, highlight your new Set in the list and click on the New Symbol button. This will display the screen that allows you to select the symbol.



f.    Click on the Select Symbol button and this will open a symbol selector screen. Here you can select which font to select your symbol from and which symbol to select. PPS has a specific font available which includes the most popular symbols used in physiotherapy note taking (details how to install this font can be found later in this document). There are also other fonts available including some standard Windows fonts such as "Wingdings" that include some useful characters you can use for symbols such as "ticks" and "crosses".



g.    Select the desired symbol and font size then click Select. This will return to the symbol screen with the symbol selected. You must enter a description; this will be used to help you select the symbol from the list.

h.    Enter a shortcut key combination if required. Shortcut keys available are the “function” keys plus an optional shift key. If you select a shortcut key, then the key can be used on the consultation screen provided that the symbols toolbar is visible.

i.    Press OK to save the new symbol. Add further symbols following the above procedure as required. The example symbol set provided includes about 20 symbols. Too many more than this and the symbol toolbar may become too big and harder to find the required symbols. You can always create a new “set” and spread your symbols in groups across more than one set.

Setting up Text Sets

a.    Setting up text sets is very similar to setting up symbols. There are two key differences: 1) instead of selecting a "symbol" you are selecting / entering a word, phrase or paragraph of text. 2) You can create sub-sets. This means that any entry can have its own collection of sub-entries.

b.    To create a new text set from the main Symbol and Text sets screen, highlight the yellow “Text Sets” folder and click the New Text Set button.

c.    Similar to creating a new symbol set, the will show a screen allowing you to give your text set a name and description. Enter these details a click Save. This will show your new text set in the list filed under "Text Sets". Highlight your new text set and click New Text Entry to add the first text entry to your set.

d.    Use this screen to give your text entry a description - this is what appears on the toolbar. Be as brief as possible with the description in order to make the toolbar entry as easy to identify as possible.

e.    Enter the text required in the main edit portion of the screen. The text you enter can be as little as one word, or an entire collection of sentences or paragraphs as required.

f.    You can use the toolbar buttons to format your text or insert symbols as required. You can also assign a shortcut key if required. The shortcut key will be available when your text entry is shown on the toolbar on the consultation screen and can be used to quickly select your more common text entries from the list.

g.    Once you have entered your details as required, click OK. This will then show your text entry on the list.

h.    If you need to add more entries to your text set, highlight the main text set name entry at the top of the list and click New Text Entry.

Adding Sub-Entries

a.    One of the additional features of text sets is to be able to add "sub-entries". This is where an existing entry in your list can include a selection of sub-entries (or even sub-sub entries!). This enables you to build your own menu of text items as shown below.

b.    Where you are using a menu/hierarchy system as above, your individual text entries do not need to have any text to be inserted into your notes - if you just enter a heading and no actual text, then this item will simply be used to open up the sub-entries to select from.

Using the Symbols Toolbar on the consultation screens

a.    The Symbols toolbar is available from the consultation screen. It is also available on any custom forms where you have selected to allow formatted free text to be entered. It is also available when viewing/updating existing consultation notes.

b.    To access the toolbar, use the Symbol toolbar button as follows.

c.    This will display the Symbols Toolbar as follows:

d.    This toolbar is a normal Windows "floating" toolbar and can be resized and "docked" to any border of the screen by clicking and dragging as required. If you have created more than one "symbol set" then you can select the required set from the drop list shown at the top of the toolbar.

e.    Once the toolbar is displayed, click any of the buttons (or use your keyboard shortcut key) to insert the symbols to the current cursor position where you are typing.

Using the Text Toolbar on the consultation screen

a.    The Text toolbar is available from the consultation screen. It is also available on any custom forms where you have selected to allow formatted free text to be entered. It is also available when viewing/updating existing consultation notes.

b.    To access the toolbar, use the TEXT toolbar button as follows.

c.     This will display the Texts Toolbar as follows:

d.    This toolbar is a normal Windows "floating" toolbar and can be resized and "docked" to any border or the screen by clicking and dragging as required. If you have created more than one "text set" you can then select the required set from the drop list shown at the top of the toolbar.

e.    Once the toolbar is displayed, click any of the buttons (or use your keyboard shortcut key) to insert the text to the current cursor position where you are typing.

f.    If you click on a text button that has sub-entries then the sub-entries will then be displayed for example on the above toolbar we click on Motor Examination:

g.    We can see that this opens up the list of sub-entries contained within Motor Examination. These buttons include a [<<Back] button to enable you to return to the previous level, and also includes the Motor Examination in bold to indicate that this is the "heading" of the sub-entries displayed. Clicking on any buttons in the list that include sub-entries will do the same.

Custom Forms

a.    Symbols and Texts can be used on Custom Forms in any "free text" type fields you have included on your form. Make sure when designing the form (PPS Menu: Tools-Custom Form Maintenance) that you select to "allow formatting" in your free-text type question. When entering free text onto a custom form the formatting toolbar (which includes the symbols and texts buttons) is shown to the left of the free text typing area in the "question heading" area.

Installing the new PPS Physio Symbols Font

a.    If you would like to use the PPS Physio Symbols font that we have provided, then this is included with the upgrade to the main PPS software. It does need to be installed before it can be used. To install the font, you can do the following:

b.    On Windows XP (and earlier versions of windows) go to the Windows Start Button, select Control Panel. The control panel allows you to install new Fonts. To do this switch the Control Panel to "Classic View" and double click on the FONTS icon.

c.    In the "Fonts" folder window that appears, select the File menu in the top left and select Install New Font.
d.    Locate the PPS Physio Font in the following folder: C: drive - PPSv4.0 folder - PPS-Database folder - Update folder.
e.    Then highlight the "PPSPhysioSymbols (True Type)" font and click [OK].
Note: As an alternative to the above in Windows XP you can bypass this procedure and install the font simply by opening My Computer, locating the PPS Physio Font in the following folder: c:\PPSv4.0\PPS-Database\Update - Copy it to the windows clipboard then locate the FONTS folder located under the c:\Windows folder and paste it in there - this will install the font for you.
On Windows Vista you can follow the similar Control Panel option as above, or go to the Start button – click Computer. Locate the PPSv4.0 folder on the C: drive, then open the “PPS-Database” folder then open the "Update" folder. You will see the "PPSPhysioSymbols" file listed. Right click on the file and select the "Install" option.
 

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