eChart Overview

UpdatedNovember 21, 2023

By Peter Hutten-CzapskiPeter Hutten-Czapski

The menu bar to the left of the patient’s Electronic Chart gives you easy access to the other parts of the chart and other resources while you are in this area. Some features add various documents to the patient’s electronic chart, and other areas give you access to clinical and internet resources without ever leaving the eChart area.

The Oscar encounter screen is designed to allow anything important to show at a glance, with all features accessible to the provider. This design minimizes the risk that the provider will miss something that is hidden on another screen, under a tab, or in another module.

(1) Opening a chart and entering a new note

In most situations the chart will open with a number of open notes. A new note window is opened at the bottom with the date and reason of encounter (transferred from your appointment) already in the edit window.
Notes can be written free text to any format that you wish, or you can use a template (26)
If you have a previously unsaved (but saved by the auto-save feature), or saved note not yet signed; instead of opening up a new window, you will be taken back to the unsaved/unsigned note – in order for you to finish the note, save and sign it. There is, however, a time window, by which the system will take you back to the unsigned note. Beyond that time window, the note will simply remain unsigned but the system will have still saved the information regarding the editor, date and time of that note.
Notes can be dictated using a “voice activated” typing program if configured.
The reason for signing a note (37) as opposed to just saving it (34) is that the system will produce a digital signature for this note. The digital signature is a mathematically calculated value (also known as a signature key) based on the text in the note. This signature key is stored away somewhere protected. This process renders the original document unalterable. When you or someone else make changes to the original signed document, a “revision” is produced which in itself is also a legal document requiring a separate signature. Notes that are just saved and not signed aren’t considered a final legal document. You should always sign your note when done.
To view a signed note you can scroll though the note if it is already opened making sure you don’t click on any part of that window. If the note is collapsed then click the “Downward pointing triangle” on the right hand side to open it.
If you want to edit a signed note, you can simply click anywhere in the window of that note (including a collapsed note). The note will be expanded into a Edit window ready for you to make changes. That’s why you will see a few blank lines at the bottom of the note. These are not real lines. It is just additional space for you to write on the note. Remember to sign and save your contribution to the previously signed note.
You can view all the revisions of a signed note by clicking the number to the right of “rev” at the right hand bottom of the Edit window.
Only the latest signed note can be edited. If you find notes that are in the previous revisions but missing in the current note, you have to copy and paste into the note while in the Edit window.
A common problem occurs when a user unintentionally clicks a signed note to view it. The note opens up in an Edit window. The user then accidentally clicks a space or return. The document then becomes an unsigned document. Every time the chart is opened by the same user he/she is then taken to that window unaware of what has happened previously. A simple way to get out of this is to sign it again.
When you click the “X” of the browser window to exit, the auto-save will still save the latest information

(2) Provider of Record

The patient’s physician, as listed in the demographics page, is listed here
The color of the background for each provider can be customized in Preferences

(3) Patient Link and data

The patient’s name here is a link to the Master record.
The age is listed here to help you ensure you have the correct chart
The phone (home or cell or preferred) is here to help you contact the patient by telephone without having to search the Master record for this information
If there is an email on record it will be listed
If there is permission to use email on record the email will be in blue and will be presented as a link

(4) Next Appointment

The patients next appointment (if any) is displayed. Clicking on the link gets you the patients appointment history.

(5) The Calculators Module

Several clinical calculators can be accessed through this drop down bar

(6) The Preventions Module

The preventions that are appropriate for the patient are listed here.
Highlighted in Red are preventions that might be overdue
Clicking on the + gives you access to add or edit the Prevention entries

(7) The Social History – part of CPP

The patient’s Social History is listed here.
Clicking on the + gives you access to add or edit

(8) The Medical History – part of CPP

You can find the patient’s medical history listed in this section.
Clicking on the + gives you access to add or edit

(9) The Allergy Module

List of the patient’s allergies if they have any.
Clicking on the + gives you access to add or edit the Allergy entries

(10) The Medication Module

Active medications are displayed here.
Clicking on the + lets you write new prescriptions (If you have authorization).

(11) The Tickler Module

Reminders that are appropriate for the patient are listed here.
Highlighted in Red are actions that are due for the patient
Clicking on the + gives you access to add or edit the Ticklers

(12) The Disease Registry

The patients chronic or long term diagnosis are entered here.
Clicking on the + gives you access to add or edit the Registry
Some diagnoses entered here (ie. Diabetes and Hypertension) will trigger the display of flow-sheets in Measurements

(13) The Forms Module

Forms displayed here are the ones that were selected in the Administration page
Commonly selected forms are the Rourke Baby Record and Antenatal Forms
Clicking on the + gives you access to add or edit the Forms
By clicking on a displayed form you can edit it

(14) The eForms Module

Clicking on a saved eForm allows you to edit it
Clicking on the + lets you select a new eForm
Commonly loaded eForms include a rich text editor called Letter

(15) The Documents Module

Scanned documents linked to the patient are listed here.
Clicking on a displayed document lets you open it to view
Clicking on the + gives you access to add or edit

(17) Lab Results

Imported Lab results are listed here.
Clicking on a lab result title opens the report
Clicking on the + gives you access to various ways to view the results

(18) Measurements

The patients latest measurements are displayed here.
If you have configured the mappings, lab results will auto-populate these measurements

(19) Ongoing Concerns

Ongoing Concerns that are highlighted for the patient are listed here.
Clicking on an item lets you edit it
Clicking on the + gives you access to add an item

(20) Reminders

Reminders that are highlighted for the patient are listed here.
Clicking on an item lets you edit it
Clicking on the + gives you access to add an item

(21) Other Medications

Other Medications that are highlighted for the patient are listed here.
You can list homeopathic and other non formulaic remedies here
Clicking on an item lets you edit it
Clicking on the + gives you access to add an item

(22) Risk Factors

Risk factors for the patient are listed here.
Clicking on an item lets you edit it
Clicking on the + gives you access to add an item

(23) Family History

Family History for the patient is listed here.
Clicking on an item lets you edit it
Clicking on the + gives you access to add an item

(24) Current Issues

Current Issues for the patient are listed here.
Clicking on an item lets you edit it
Clicking on the + gives you access to add an item

(25) Decision Support

Evidence based rules as developed will highlight potential interventions for the patient here.
Based on My Drug Ref.

(26) Template Select

You can select from enabled templates here to fill the encounter with boilerplate text

(27) Search

Any of a number of search possibilities can be launched here from clinical to general internet resources
New for OSCAR 12 is integration of search with Medline Plus
Text selected in the encounter will auto fill the search bar to speed searching
If you have a preferred or paid search service you can have OSCAR 19 configured to display those options in oscar.properties. The following are example settings for UptoDate

customSearchUrl=http://www.uptodate.com/online?search=
customSearchName=UpToDate

(28) Filter Encounters

Filter elements in the chart by criteria for viewing and/or printing.
Criteria include provider, provider type (eg doctor) and issue (eg diabetes)

(29) CPP Select for Printing

Clicking this item will toggle the Cumulative Patient Profile for printing.
Then clicking on the print icon (41) will open a dialog for you to select all or a date range for printing to PDF

(30) Rx Select for Printing

Clicking this item will toggle the Prescriptions for printing.
Then clicking on the print icon (41) will open a dialog for you to select all or a date range for printing to PDF

(31) Toilet Roll / Note

Despite vigorous efforts to stamp out the term, users affectionately refer to chart entries as the toilet roll
Rev is a revision number for the entry, clicking on it will display all the edits
Clicking on the edit link of an item lets you edit it to add a new revision
Clicking on the printer icon selects the entry for printing with the print icon (41)
Clicking on a down or up arrow will window shade the entry toggling its visibility
Clicking the timer will paste the time the chart opened and the current time
Markup buttons are present for Bold Italic Unordered List Ordered List Heading and link that will format the text after saving

(32) Display Issues

Clicking on this icon opens the bottom of the active entry so that you can select appropriate issue(s) from previous ones
Issue(s) selected for the encounter will auto-populate the billing form

(33) Unresolved Issues

If the issue(s) for the encounter are new you can add them with this selection box.
Issues selected for the encounter will auto-populate the billing form

(34) Save

Rarely needed as the system auto saves every 30 seconds
It does not authenticate the note, for which you need to sign off the entry.

(35) New Note

Adds an entry to the toilet roll.

(36) Sign & Save

The usual exit for an entry for which there is no billing.
Charting telephone calls and notes without the patients presence are often finished with this button

(37) Verify & Sign

Signs off the entry for the provider
Used by supervisors to verify a “learners” note, ie resident, clerk, etc.

(38) Sign, Save & Bill

The most common exit for a face to face encounter

(39) Note Browser

Browse the encounter notes while writing a new note with Multiples select & print notes supported. Also have Document Browser integrated

The note browser allows for efficient filtering and review of the chart
By default all the notes are selected, but you can select any of them
You can click the PDF button to cause a PDF file to be generated from the selected notes (similar to those from the PDF menu in the echart)
You can print the Print button to print in the format that you see displayed

(40) Exit

Can be used as a “safety” if a large note or amount of work is entered and you want to move around in E-Chart or go to another site.
Rarely used unless you plan to return to the note later to finish (and sign) it off
Does not sign note.

(41) Print Notes

Print Dialog

You can generate a pdf for printing today’s saved note clicking the printer icon on the right hand bottom of the echart screen and click on the “Today” link.
Print all the encounter notes by clicking the printer icon on the right hand bottom of the echart screen (default will be “all”), then click “PDF”
if you want to print notes between 2 time periods, you can click the printer icon on the right hand bottom of the eChart screen, enter the 2 dates in the respective fields (exclusive of the end date) then click “PDF”
if you want to print any selected notes, you have to click the very tiny printer icon on the right upper corner of each encounter box, followed by the larger printer icon on the right hand bottom of the echart screen (default will be automatically set as “Selected” ) then click “PDF”
***Remember: the old chart and split chart are single documents so there is no real easy way to print portions of these notes. What you can do is to copy and paste the portion of notes you want to print into a text editor such as the Rich Text Editor in OSCAR then print it from there
for the really sophisticated user, you can use the filter (button is next to Calculators) to print notes based on individual editor(s) or role(s) – i.e. all doctors notes(41)
You can also print notes from the Note Browser

(42) HRM Documents

If your hospital offers reports in the HRM standard, they can be imported into Oscar and will be stored here

(43) Resolved Issues

Resolved issues get listed here

(44) Spell check Button

A built in spell checker is available for the encounter that works in all browsers
Alternately we recommend using Firefox and the Med Spell add in for Canadian Medical Spelling “on the fly”

Set your preferences to display previous encounter notes

go to preferences tab (Pref)
click “Set Stale Date for Case Management Notes”
if you have never put anything in then the default is to only show notes from the last 30 days; you can get the default value by clicking the “clear” button; or you can select from the drop down a value, e.g. 6 for 6 months of notes. If you select ALL the system will open all previous notes. If you have a “thick chart” it may take some time! My preference is 12 months.
all the rest of the notes outside of your preferred duration will be “collapsed” and require you to click the “Downward pointing triangle” on the right hand side to open it