Provider Manual · Part VII

The patient chart

Everything in one record: find the patient, read the chart's tabs and header strip, keep problems, allergies, demographics, and vitals current, and review past encounters alongside upcoming visits.

13 sections~35 min read7 screenshots
VII
Part VII

The patient chart

Everything in one record: find the patient, read the chart's tabs and header strip, keep problems, allergies, demographics, and vitals current, and review past encounters alongside upcoming visits.

7.2Chart layout & tabs

Read the chart: layout, tabs & in-chart search

The chart screen has two zones: the patient header strip across the top (covered in the next section) and the Chart Review card below it, with a row of section tabs. Encounters is the default tab.

EncountersNotesLabsImagingMedicationsProceduresMediaLetters

Those eight are the row a default practice sees. Five more — Immunizations, Medications given, Prenatal, GYN Screening, and Brain Health — are conditional and slot in after Medications only where they apply, so don’t expect them on every chart. Each fails closed — if the setting is still loading, the tab stays hidden rather than flickering into view:

  • Immunizations appears only if your practice has enabled it as an additional feature (see Practice setup).
  • Medications given appears when the practice has turned on In-office medications: every injection and dose given in clinic, with repeating doses (see Chart tab, schedules and the due list).
  • Prenatal needs obstetrics enabled and at least one pregnancy episode on this patient, so it shows up on the patients it applies to rather than on every chart.
  • GYN Screening (cervical cancer screening) needs obstetrics enabled, and is left out when the patient’s recorded sex is male.
  • Brain Health appears when the neurology brain-health feature is enabled for the practice.

A chart reopens on the tab you were last on. With nothing remembered, providers start on Encounters; staff whose first tab would be GYN Screening start on their own first tab instead (for the front desk, Media).

For staff accounts, each tab shows only when the staff profile holds the matching permission — a profile with no chart permissions sees No chart sections available instead.

  1. Jump between tabs. Cmd+1–Cmd+9 (Ctrl+1–Ctrl+9 on Windows) go straight to a tab — hover any tab to see its shortcut hint. Only the first nine tabs you can actually see get a number, so on a chart carrying the optional tabs the last ones are click-only. Tabs load on first visit and then stay loaded, so switching back is instant. If the row overflows the window, chevron buttons appear to scroll it.
  2. Search inside the chart. The magnifier at the right end of the tab row expands a Search… box (Ctrl+F focuses it). It full-text searches the patient’s Notes, Labs, and Imaging, groups the matches under headings, and clicking a result jumps to that item in the matching tab.
  3. Pick a layout. The small monitor icon on the header toggles between the default horizontal bar (Switch to vertical layout) and a vertical left sidebar (Switch to horizontal layout). The sidebar lists, top to bottom, Allergies, Problems, legal representatives, Other History, Psychiatric History (when enabled), Immunizations (when enabled), Implantable devices and Goals & health concerns (when enabled), Preferred Pharmacies, Care team, Referral Communications, Amendments, and Disclosures, each as an expandable section. Referral Communications only appears when this patient came in through an inbound referral, and an active-pregnancy chip sits in the panel for obstetric practices. Two sections show only in this vertical layout, and only when the practice has turned the feature on: Amendments, when the chart has a record correction request (see Correction requests in the chart), and Disclosures, the patient’s disclosure history (see Disclosure history). When your practice has a provider app, an app button sits above the clinical sections here and next to Send to ECG in the horizontal bar (see Apps in the chart). Implantable devices and goals are also reachable from either layout in Patient Information.
  4. Order without opening a note. Physicians can press F7 or Ctrl+O from the chart to open Create Orders directly — see Standalone orders.
A full patient chart with the header strip showing vitals, Allergies, Problems, Pharmacies and Other History, the default tab row Encounters, Notes, Labs, Imaging, Medications, Procedures, Media and Letters, and the Encounters tab open with Sort and Filter chips, the Future Visits toggle pressed, the Customize columns icon at the right end of that row, an Upcoming Visits panel, and the encounter history table beneath it
The whole chart at a glance: header strip on top, tab row beneath it, and the default Encounters tab with upcoming visits above the history. (This picture shows the older Sort and Filter chips; the list now has the one-row toolbar described in Encounters & notes.)
Know the search scope: in-chart search covers Notes, Labs, and Imaging only — it does not search medications, media, or letters. Browse those tabs directly.
7.3Patient header strip

The patient header: identity, vitals & safety at a glance

The header strip stays in view no matter which tab you’re on. It packs the patient’s identity, latest vitals, allergies, problems, and preferred pharmacies into one bar — each block is clickable and drops down its detail.

Identity

Avatar initials, name, MRN, age, DOB, and sex. Hover for a demographics summary tooltip; click to open Patient Information — for physicians and admins a full workspace page in its own Info: {patient} tab, and for staff without a patient-chart permission the same content as an overlay dialog. In the vertical layout the MRN is a badge — Click to copy MRN.

Vitals readout

The most recent Wt: and Ht: with a recency suffix such as “(today)” or “(3d ago)”, or No vitals recorded when empty. Clicking it opens the vitals action menu — see Vitals & trends.

Allergies

Recorded allergies are named in red, most severe first (for example Allergies Penicillin, Sulfa +2), with the full list in the tooltip. The dropdown sorts severe-first with Severe / Moderate / Mild / Unknown pills. Add New records one, and clicking a listed allergy opens it for editing.

Problems

A live count; the dropdown has All / Active / Inactive / Resolved filter chips, sorts active problems first, and badges the rest. Add New adds to the list.

Pharmacies

Drops down the Preferred Pharmacies list. The gear opens Manage and Select Pharmacies — set a primary, remove entries, or search under Add New Pharmacy. See Pharmacies for the full workflow.

Other History

Opens past medical, surgical, social, and family history in one dialog (Past medical history). The button is there for physicians and admins; staff need the patient-history permission (patient_history.manage) to see it at all.

Sticky note

The sticky-note button opens a draggable per-patient note that autosaves; it turns yellow, with a count, when there is a note. Physicians and practice administrators write their own; other staff can write one when given “Write your own sticky notes on charts and share them with the practice.” Notes someone shared with the practice show to everyone with chart access, read-only (View only).

Chart alerts (safety concerns, legal representatives and other flags) show as chips under the name; see Chart alerts.

Icons left of the name, and their hotkeys

The buttons to the left of the patient’s name (sticky notes, care programs, APCM, remote monitoring, pregnancy) are icons; three or more stack in two rows so the header stays short. Hover one for its name and shortcut. The default hotkeys are Alt+N sticky notes, Alt+C care programs, Alt+A APCM and Alt+R remote monitoring (Option on a Mac); they work from the note editor too, and you can change them under Chart in Settings → Hotkeys. When the window is narrow, Problems, Pharmacies, Care team, Psychiatric and Other History shrink to icons that still show their name and count, and widen again when there is room. The Allergies button never shrinks to an unlabeled icon.

Pharmacy edits aren’t saved until you click Save Changes in the manage dialog — closing it discards your changes. Removing the primary pharmacy silently promotes the first remaining one to primary.
APCM practices see one more chip: if your practice has APCM enabled, primary-care physicians also get a heart-pulse status chip (for example APCM: Eligible or APCM: Enrolled) that can document verbal enrollment consent — see the APCM program.

When Value-Based Care is enabled, the Care programs chip opens the shared enrollment and care-plan drawer. See Enroll a patient in a care program.

7.4Problems & allergies

Maintain the problem list & allergies

Problems and allergies are managed straight from their header dropdowns, and both follow the same add–edit–delete pattern. Keeping them current matters beyond the chart: the allergy list feeds the medication safety checks (see Safety checks).

  1. Open the dialog. Click Problems → Add New, or press Ctrl+Shift+P anywhere in the chart; for allergies it’s Allergies → Add New or Ctrl+Shift+A. To edit, just click an existing entry in the dropdown.
  2. Name the entry. A problem requires an ICD-10 Code: type into Search ICD-10 codes… and press Enter (or the magnifier) to open the code search; the official description appears beneath the field once chosen. An allergy opens one window, Add allergy (or Edit allergy), whose Allergen box says Type a medicine, food or substance: pick a match from the allergen list (it shows its type, for example Medication · matched to the allergen list) or choose Use “…” as typed, which warns “Saved as typed — not matched to our allergen list, so automatic checks may miss it.”
  3. Duplicates are refused. An allergen or an active problem already on the list can’t be added twice: the window says, for example, “Penicillin is already on the list…” or “… is already on the active problem list.”, with Open it to edit the existing entry instead.
  4. Fill in the detail and save. Save with Add Problem or Add allergy. When editing, the button reads Update Problem / Save and the code or allergen is read-only — only the details below can change. If you leave an allergy’s reaction or severity empty, Hero asks “No reaction or severity chosen. Save them as unknown?” with Save as unknown or Choose now.
  5. Delete with confirmation. Open the entry and click Delete; a confirmation (for an allergy, Delete {allergen}?) appears before anything is removed.

Problem details

  • Notes — free text, up to 5,000 characters.
  • Severity (1-10) — annotated (Mild) 1–3, (Moderate) 4–7, (Severe) 8–10.
  • Status — Active, Resolved, or Inactive.
  • Chronic Condition checkbox.

Allergy details

  • Reaction — Rash, Hives, Itching, Swelling, Breathing trouble, Anaphylaxis, Stomach upset, Nausea, Vomiting, Diarrhea, Headache, Other, or Unknown. Other asks you to Describe the reaction (required). When editing, earlier details stay on file and show as Details on file: ….
  • Severity — Mild / Moderate / Severe / Unknown; severe allergies sort to the top in red. Choosing Anaphylaxis asks “Anaphylaxis is a severe reaction. Set severity to Severe?” (Set Severe or keep yours).
  • Note — optional, behind Add a note; up to 5,000 characters.
Problems dropdown open from the chart header with All, Active, Inactive and Resolved filter chips, a problem list carrying Inactive and Resolved status badges, and an Add New button
The Problems dropdown: filter chips, color-coded status dots with Inactive / Resolved badges, and + Add New.
Codes and allergens can’t be renamed. Once saved, a problem’s ICD-10 code and an allergy’s allergen are locked — to correct a wrong one, delete it (or mark the problem resolved) and add a new entry.
“No known allergies” is something you record, not an empty list. A chart with no allergies reads No allergies recorded, which means nobody has asked yet. After asking, click No known allergies to record it; the chart then shows a green No known allergies line with who recorded it, and Clear takes it back. It can’t be recorded while allergies are on the list, and typing “no known allergies” as an allergen is refused (“That isn't an allergen.”, with a Record no known allergies button when it applies).
When a patient asks to remove an allergy from the portal, it stays on the chart until a clinician decides. Opening it shows who asked and when, with Remove allergy or Keep it; the patient is told when you keep it. An allergy your care team recorded can’t be edited or deleted from the portal.

An imported problem can retain the diagnosis wording from its source document alongside its code. Review the original description when reconciling it rather than assuming the catalog wording captures every detail.

7.5Demographics & insurance

View & edit demographics, insurance, and patient billing

Click the patient’s name or avatar in the header strip and Hero EMR opens Patient Information — one screen for everything administrative about this patient. For physicians and admins it is a full workspace page in its own tab titled Info: {patient}; staff without a patient-chart permission get the same content as an overlay dialog. Its header repeats the identity with chips for MRN, DOB, Age, and Sex, and it opens on Demographics.

Its tabs sit in a grouped sidebar: Demographics (plus Goals & health concerns, Implantable devices and More demographics when the practice turns them on) under Patient; Appointments, Chart Sharing, Forms & Letters, Media, Prescriptions, Prior Auth, Homework, and Questionnaires under Care workflow; Custom Billing Rules, Insurance, and Invoices & Charges under Financial; and Export Health Information (when turned on) and Outbound Comms under Administration. The financial and administrative tabs are permission-gated, so a plain physician account works with ten tabs plus any of the optional ones the practice has turned on.

The whole screen has its own chapter: the Patient Information overview for who sees which tab and the ?section= deep links, Demographics for the edit form and its validation, and Insurance & eligibility for policies, the free eligibility check and the paid COB check, and the cash-pay bypass.

The Patient Information workspace open on Demographics in its own Info: Michael Chen tab, with the left sidebar grouped as PATIENT (Demographics), CARE WORKFLOW (Appointments, Forms & Letters, Prescriptions, Prior Auth, Questionnaires), FINANCIAL (Custom Billing Rules, Insurance, Invoices & Charges) and ADMINISTRATION (Outbound Comms), the header chips MRN, DOB, Age and Sex, an Edit button, and the Identity, Contact, Address and Emergency Contact cards
Patient Information as a workspace page — grouped sidebar, identity chips, and the Demographics read cards. (This picture predates the Chart Sharing, Media, Homework and optional tabs.)
7.6Encounters & notes

Review past encounters, notes & upcoming visits

The Encounters tab — the chart’s default — is the visit history: every encounter in a sortable table, a side-by-side preview, and an optional panel of upcoming visits. The Notes tab is the note-centric view of the same record.

  1. Scan the history. Columns are Date, Type, Provider, Specialty, and Chief Complaint, and dates render in your organization’s time zone. (Billing staff who see amounts but do not write notes start on Date, Type, Provider, Status, Billing, Claim and Balance instead.) Badges sit next to the type and tell you the state of each visit at a glance: Unsigned note while a note is still a draft, Signed once you’ve signed it, plus No-show, Rescheduled, or Cancelled where the appointment didn’t happen, and an eye-off icon on a visit hidden in the patient portal (hover it for who it is hidden from; the Status column shows the full label, such as Hidden from parents, Hidden from portal or Note hidden — see Hidden visits & items). Switch on the optional Status column and those badges move there rather than doubling up. Long histories load more as you scroll; the foot of the list reads Showing N · scroll for more while more are coming.
  2. Use the one-row toolbar. Encounters and Notes share the same toolbar, left to right: the saved view menu (All encounters, By me, My specialty, then your own saved views; it reads Custom view after you change something, and a • marks a saved view you have changed), a bookmark icon Save as a view while the view is unsaved or changed, Filters with a count of the filters in use, an Imported records menu (only on charts with records brought in from another system; its tooltip explains “Encounters lists visits and records imported from another EMR. Clinical documentation is under Notes.”), and the sort menu (Newest first, Oldest first, Type A–Z, Provider Z–A…). At the right end are three icons: Show future visits / Hide future visits, View settings, and Show preview / Hide preview. By me and My specialty appear only for users with a clinician profile.
  3. Set up the list in View settings. Filters, View settings and Save as a view all open one screen, View settings · Encounters, with your views across the top, filters on the left, and sort and columns on the right:
    • Filters: Encounter date (Any time, 30 days, 90 days, 1 year, Custom), Provider (Anyone, By me, My specialty, or pick specific providers), Imported records, Documentation status (Draft, Completed, Signed, Imported), Upcoming visits (List future visits at the top), and Encounter types (only the types on this chart, named as the Type column shows them). Clear filters empties them.
    • Sort: a field and a direction.
    • Columns: switch on the ones you want and drag them into order. Beyond the five default columns you can add Summary, Status, Visit Reason, Referring provider, PCP, Last Updated, and Signed, plus Billing, Claim, and Balance — money columns that are absent for users who can’t see financial amounts. Reset to defaults goes back.
    Click Apply view to use it now, or Cancel.
  4. Save views you reuse. In the footer, Save as new view asks you to Name this view (up to 40 characters), with Include columns if the view should also bring its columns, then Save view. After changing a saved view, Update “{name}” saves over it. Next to the selected view, the pencil renames, the copy icon duplicates, and the bin deletes it. You can keep up to 20 saved views (“You have 20 saved views. Delete one first.”). Saved views are your own; nobody else sees them.
  5. Pick the view every chart opens on. The star next to the selected view (Open charts on this view) makes it your default: every chart you open starts on it, marked with a star in the list. Click the star again to stop, and charts open on All encounters. A link to one particular encounter or note still opens on everything, so its row can be found.
  6. Preview a visit. Single-click a row to open a split-pane preview — note content, orders, and charges (only the parts your role may read) — and collapse it with the eye icon (Hide preview / Show preview). Double-click to open the same preview as a near-full-screen dialog instead.
  7. Open the visit itself. A thin action strip sits above the split-pane preview: Encounter on the left, and on the right an Open encounter button that takes you into the note writer for that visit — to keep writing a draft, or to add an addendum to one you’ve already signed. On a row from the Upcoming visits panel the same button reads Begin encounter and starts the visit instead. The strip belongs to the split-pane preview only, so if you double-clicked into the full-screen window you’ll need to close it and single-click the row instead. Staff accounts see the strip only with an encounter permission on their profile.
  8. Watch upcoming visits. With future visits shown (the calendar icon on the toolbar, on by default), booked appointments head the table under Upcoming visits (N), in the same columns: date and time, visit type with the location or Virtual Visit, provider, and any visit notes. Cancelled, completed, no-show, held, and already-started visits are filtered out automatically; with nothing booked the group is simply not there.
  9. When the list is empty. No encounters match these filters (with Clear filters) means the filters hide everything; No encounters found means the chart has none; No other encounters. means every visit is already listed under Upcoming visits.
  10. Read notes on the Notes tab. The note list opens any note in a preview pane beside it, with the same toolbar and View settings as Encounters. Columns are Date, Note Type, Document, Specialty, and Author (add Summary or Referring provider); a note that has been signed shows a Signed: date beneath its date, and Document shows a dash where the note came from a visit rather than an imported or uploaded document. The views are All notes, By me, My specialty and your own; the filters are Date of service, Author, Imported records, Note status and Note types; sort by date, type, specialty or author. In the note writer’s Chart Review, clinicians also get My last note, which opens the last note you signed for this patient using the whole pane. An empty list reads No notes match these filters or No notes found for this patient.
  11. To change a signed note, open its visit. Signed notes are never edited in place, and the Notes tab has no editing controls at all — it is a reading surface. Go back to the Encounters tab, single-click the visit, and click Open encounter in the preview’s action strip (or double-click the appointment on the calendar). Hero EMR asks whether you want to create an addendum, copies the signed note as your starting point, and you sign the amended version when you’re done. Full walkthrough in Change a visit after you’ve signed it.
  12. Read earlier versions with History. Once a note has been amended, the list shows the current version only — the addendum takes the original’s place rather than sitting beside it as a second row. Nothing is lost: select the note and click History, the clock button in the preview toolbar beside Print (tooltip: View version history). A Version History column opens listing every version by date and time with its author. Click an entry to read that version in full. The version you’re reading is badged Current; the Active badge that every entry carries means something else — that the version’s full text is still stored and instantly readable, rather than moved to long-term storage (Archived) once it passes your practice’s retention window.
Encounters tab with the preview pane open, showing a New Patient Visit with Draft and Telehealth badges and a Visit logistics card
Single-click opens the split-pane preview — here a draft telehealth visit with its Visit logistics card.
Notes tab with a sortable note list, a Progress Note selected, and its preview shown alongside
The Notes tab: pick a note on the left, read it on the right.
Encounters tab split-pane preview with the Encounter action strip above it and a blue Open encounter button at its right-hand end
The action strip above the split-pane preview — Open encounter takes you into the note writer for that visit.
The upcoming-visits panel is read-only. Rows are display-only — booking or changing appointments happens in the scheduler (see Booking & rescheduling), and visits shown as Virtual Visit run through telehealth.

A signed visit was entered by mistake

Physicians and administrators can right-click a signed visit and choose Mark as entered in error…. Read the preview, enter a Reason, and confirm with Mark entered in error. The visit leaves the encounter list while its notes remain available under Notes with Status: Void.

The preview identifies claims that have not reached the insurer and can be cancelled, or unpaid charges that can be removed. Submitted claims, payments, or other blocking activity can require correction first. Diagnoses and medication changes stay in the chart and must be corrected separately if wrong.

For a future appointment marked done by signing, choose whether the patient is still coming. Restoring puts it back on the schedule with reminders. Leaving reminders off does not cancel it; cancel from the calendar if appropriate.

7.7Vitals & trends

Vitals: read the strip, record during a visit, review the trend

The header’s vitals readout shows the most recent Wt: and Ht: with a recency suffix — “(today)”, “(yesterday)”, “(3d ago)”, or a date — or No vitals recorded when there’s nothing yet. Clicking it opens a small action menu for everything vitals-related.

  1. Open the action menu. Click the Wt: / Ht: readout. The three standing actions are Open height and weight trends, Pull latest vitals into note, and Add encounter vitals. Obstetric practices get a fourth, OB, during a visit — it opens prenatal observations for the encounter, or offers Start pregnancy episode… when there isn’t one yet.
  2. Review the trend. Open height and weight trends opens the Growth & vitals trends modal. Three tiles across the top give you Latest weight, Latest height, and Most recent at a glance; below them, Weight and Height tabs chart every recorded value point by point, each with a Date / Value / Source table under the chart. Children get a third tab, Growth, plotting the measurements against CDC growth percentiles — it appears for patients under 20 and opens selected by default under 18.
  3. Record vitals during a visit. Add encounter vitals opens a dialog subtitled Save measurements for the patient on this encounter. It records Measured at (required), Weight and Height with unit selectors (they start in the units the vitals bar shows, pounds and inches unless you changed them), Head circumference with its own cm/in selector, Blood pressure (Systolic/Diastolic), Heart rate, Temperature with its unit, Oxygen saturation, Respiratory rate, Pain (0-10), and Notes. Finish with Save vitals; at least one value is needed (“Enter at least one vital value.”). The note’s vitals card shows weight in both systems, for example 173 lb (78.5 kg).
  4. Record more vital signs (optional feature). With More vital signs turned on in Admin → Additional Features (off by default), the dialog adds a More vital signs group: Inhaled oxygen concentration (%), Inhaled oxygen flow rate (L/min), BMI percentile (age 2-20), Weight-for-length percentile (under 2) and Head circumference percentile (under 3). You type the percentile from your growth chart; Hero checks the range (0 to 100, or 0 to 80 L/min for flow) before saving, for example “BMI percentile (age 2-20) must be a number from 0 to 100.” The values appear in the vitals history and in the vitals dot phrase when recorded.
  5. Stamp vitals into the note. Pull latest vitals into note inserts the most recent measurements into the encounter note you have open, so the documented vitals match the chart.
Vitals entry is part of a visit, not free-standing. Pull latest vitals into note and Add encounter vitals stay disabled unless a draft encounter note for this patient is open — their tooltips read “Open an editable encounter note to pull vitals into the note.” and “Open an editable encounter to add encounter vitals.” Start the note first (see the encounter workspace); of the standing three actions, only the trends view is not tied to an open note, and the OB action needs an encounter too.
7.7aPhone health data

See the health data a patient shares from their phone (Apple Health)

When a patient shares health data from their iPhone’s Apple Health through the Hero patient app (steps, sleep, heart rate, blood pressure, weight, glucose and more), you can see it in the chart. A small phone mark next to the weight and height in the chart header means the patient shares phone health data.

  1. Click the weight and height readout in the chart header to open its menu.
  2. Choose Phone health data. It is offered only when the patient shares data. Growth & vitals trends opens on the Phone data tab.
  3. Check when it last synced. The top line reads, for example, Last synced Oct 27, 2026, 6:59 PM from Apple Health, with the devices it came from.
  4. Pick the period and the view. Choose 7, 30 or 90 days, and Graphs (a trend card per type, with the average) or Table (the daily values).

The types are Steps, Walking + running distance, Active energy, Workouts, Sleep (per night), Heart rate (daily average) with its range, Blood pressure, Weight, Glucose, SpO2 (oxygen saturation), Temperature and Respiratory rate. Weight and distance follow the chart’s US or metric setting. If nothing came in during the period, it says so; if the patient has never shared, it reads This patient hasn’t shared health data from their phone.

These readings are the patient’s, not the practice’s. The tab says: “Shared by the patient from their phone's health app. The practice has not measured or verified these readings.” They are not encounter vitals; record measured vitals with Add encounter vitals (above). Viewing needs permission to view patients or manage vitals. How patients turn on sharing is in Health data & devices.
7.7bImmunizations & MIIS

Record vaccines and reconcile Massachusetts registry history

The chart’s Immunizations tab is enabled under Admin → Additional Features → Immunizations. Registry exchange is a separate connection: Hero turns exchange on for your practice — ask support. Saving a vaccine in Hero does not by itself establish that MIIS received it.

  1. Configure the practice connection. An administrator or staff member with immunization-registry administration access opens Admin → Immunization Registry → Connection, selects Massachusetts, and enters the site identity and credentials provided during MIIS onboarding. Use the MIIS-assigned site PIN for the sending and administering facility codes.
  2. Complete testing before live reporting. Save the connection, test it, and complete MIIS onboarding approval. The Training badge means the connection is not live reporting. Moving to production requires a passing production test and the Switch to production confirmation. Turn on Enable registry exchange and save.
  3. Choose exchange behavior. Sync Settings controls reporting timing, Doses administered here, Historical doses, and Corrections and retractions. You can also configure Import registry history automatically and Look up patients before their visit. Use Activity to inspect reporting outcomes.
  4. Document the vaccine accurately. In the immunization editor, expand Details (lot, manufacturer, site, dose, VIS) and record the applicable administration details. Funding source and VFC eligibility use registry-specific choices when configured. A saved value that needs review for the selected registry is identified.
  5. Reconcile the patient’s history. On Immunizations, use Check registry. If several possible patients return, compare their identifying details before selecting one. Review new doses and Recorded differently here conflicts; Add all applies to the new-dose group.

State forecast is read-only information from MIIS. Review it alongside the chart’s Due & recommended area. A failed or unmatched lookup does not mean the chart agrees with the registry.

Other registries, the standard CDC format, copy-and-paste exchange, recording a refused vaccine, and the registry history and forecast in the chart are covered in Immunization registry. Every report sent to the registry is also listed in the patient’s disclosure history when your practice has it turned on.

MIIS sharing preferences are managed in the registry portal. Hero does not offer a new reporting opt-out for MIIS. If a patient was already paused, Resume exchange resumes Hero exchange without changing the MIIS sharing preference; review reports skipped during the pause.
7.32Coded family history

Family history picked from a list of conditions

Family history lives in Other History (the header button, or the Other History section of the vertical patient panel), on its Family tab. With Coded family history on (the default; a practice administrator can turn it off in Admin → Additional Features), adding a row is quicker and every condition you pick is saved with its standard clinical code, so it is shared correctly with other practices. Conditions patients pick from the list in their portal health history are saved with the same codes.

  1. Click Add family history. Pick the Relative with one click: Mother, Father, Sister, Brother, Daughter, Son, the four grandparents, Aunt, Uncle, Cousin, Half-sibling, or Other relative (which asks for a Relationship detail).
  2. Search the Condition. Type part of it (for example type 2 diab or breast cancer). About 120 common conditions are listed in everyday words, with the clinical term underneath; choosing one also fills in its ICD-10 code. Not on the list? Choose Use “…” (not on the list) to keep your own wording, and add an ICD-10 code yourself if you want one.
  3. Finish the row. Add Age of onset, whether the relative has died and their Age at death, and Notes as before, then click Add family history (or Save changes when editing).

In the family history table, a coded condition shows its clinical term in small print above the ICD-10 code. Turning the feature off brings back the plain form (a Relationship menu and a free-text Condition); codes already saved are kept.

7.32aPast medical history

Record past medical history (PMH): add, edit or delete a condition on the Medical tab

Past medical history (PMH, PMHx) lives in Other History (the header button, or the Other History section of the vertical patient panel), on its Medical tab, next to Surgical, Social and Family. When the patient has medical history, the dialog opens on Medical. Notes brought over from a previous system stay at the top, read-only.

  1. Click Add condition.
  2. Search the Condition (Search, for example asthma or high blood pressure) and pick it; a listed condition is saved with its clinical code. Not on the list? Choose Use “…” (not on the list) to keep your own wording, and optionally search an ICD-10 code (picking one fills the condition).
  3. Add when, if known. Year, then Month and a day if you have them: “When it started or was diagnosed; a year is enough.”
  4. Pick a Status (Ongoing, Resolved, In remission or Childhood), add Notes if useful, and click Add condition.

The table shows Condition, Code (the ICD-10 code, the clinical term, or uncoded), When, Status and Source (for example Patient-reported or Staff-recorded).

Edit or delete a condition

Use the pencil to edit a row (Save changes), or the trash icon to delete it; confirm “Delete “{condition}” from past medical history?”. If someone else changed the row meanwhile, Hero reloads the latest version instead of overwriting it.

Free-text notes

For history that isn’t a single condition, type in Past medical history notes (Childhood illnesses, hospitalizations, major injuries…) and click Save notes. The notes show who wrote them and when. If someone else saved the notes while you were typing, Hero keeps your text and asks you to choose Keep my version or Use current notes.

Reviewed, or nothing to record

  • Mark reviewed records that the history was reviewed as complete, with your name and the date.
  • With nothing recorded, Patient reports no significant past medical history records a documented negative instead of leaving it blank.
  • Providers see Verify on each condition and on the notes to attest them as clinically reviewed (Unverify clears it).

Where it shows

The chart’s Other History summary starts with PMHx: and the first conditions (and PMHx notes:). Before a visit, the Prep Medical history card lists them under Past medical history, or says None reported or Not recorded; opening history from that card goes straight to the Medical tab. Who can open Other History is in Patient header strip. Active diagnoses still belong on the problem list (Problems & allergies).

7.37Hidden visits & items

See who a hidden visit or item is hidden from

When a clinician hides a visit, a note, or one item from the patient portal (for example a teen’s confidential visit; see Teens & guardians), staff screens now say exactly who cannot see it. Nothing is hidden from staff, and these labels never change who can see what; they only say it. Everything hidden stays part of the legal record.

LabelWhat it means
Hidden from parentsParents, guardians and other representatives can’t see it in the portal; the patient still can.
Hidden from portalHidden from the patient and from parents, guardians and other representatives. A note hidden from the patient (including a psychotherapy note) is always hidden from parents too.
Note hiddenA note on the visit is hidden from the patient and parents; the rest of the visit is visible.
Portal restrictedPart of the visit is hidden in the portal (shown when Hero can’t say more).

Hover a label for the full sentence, for example “Parents, guardians and other representatives can't see this in the portal. Sam still can. Still part of the legal record.”

Where you see them

  • The chart’s Encounters and Notes lists, the card view, and the chip in the note header.
  • Hidden from parents chips on a minor’s labs, files, questionnaires, appointment details and imported records, worked out by the same rules the portal follows.
  • Billing: Confidential teen visit on the patient’s account timeline, on invoices and in the visit picker for charges, and a staff-only banner on the statement preview. Statements are not held back.
  • Outbound Comms rows for a hidden visit say what parents get.
  • The letter writer says who will see a letter in the portal, for example “This visit is hidden in the portal, so this letter won't show there for Sam or for anyone who reads Sam's records. Print or fax it if they need it.” (see Forms & Letters).

Hide one lab or file from parents

On a minor’s chart, a filed lab result (in Labs) or a file (in the document viewer) has a Hide from parents and guardians switch, with a line saying what parents see now. Physicians, and staff allowed to manage portal visibility, can change it; everyone else reads A doctor can change this. It is not shown on an adult’s chart.

7.38Chart alerts

Chart alerts under the patient’s name

A chart alert is a one-line flag the next person opening the chart must see: a safety concern, a legal representative, a controlled-substance agreement, a parent or guardian note. Alerts show as chips under the patient’s name in the horizontal header (and under Chart Alerts in the vertical panel), most severe first, until someone resolves or dismisses them. A questionnaire safety answer (for example a positive suicide-risk screen) raises one on its own. A questionnaire answer your practice set to Chart label only (for example Firearm access) adds a Warning label instead, with no to-do or notification; resolve or dismiss it like any chart alert.

  1. Add one. Add alert opens Add chart alert (“Shown on the patient header until someone resolves or dismisses it.”). Choose the Type (Chart alert, Safety concern, Legal representative, Controlled substance, Parent / guardian) and Severity (Critical, Warning, Info), write the Title (“One line — this is what shows on the patient header.”) and optional Details, then Add alert.
  2. Open one. Click a chip for its details. A questionnaire safety alert names the screen in its headline, keeps the worst score and adds the newest (for example “… (score 17/27, Oct 10, 2026) · Latest: 10/27 on Oct 10”), says who its urgent to-dos went to, and has View answers.
  3. Close it with a note. Resolve (“Say what was confirmed or done”) or Dismiss (“Say why this alert does not apply”) asks for a note that is kept with the alert. If someone else changed or closed it while you had it open, Hero shows the latest version, or lets you Add my note to their closing.
Only a clinician can close a Critical alert. Resolving, dismissing or changing a Critical alert needs a physician, a practice administrator, or staff given “Resolve, dismiss or change critical chart alerts, such as a suicide-risk screen.” (the Nurse preset has it; medical assistants and the front desk do not). Everyone else reads “Only a clinician can resolve this alert. Tell {doctor}.” A clinician who ticks their questionnaire safety to-do closes the alert too, once they have ticked a to-do for every screen the alert stands for; a newer unticked screen keeps it open. Adding and closing other alerts needs patient-management permission.

Patient lists can find patients by chart alert, and show a Chart alerts column (see Custom search builder).

Need help? Email support@heroemr.com.