Receiving and reconciling health records

Where received health records land

Records sent to your practice’s secure addresses arrive in Inbox → Health records (right after Faxes). The folder’s badge counts the files still new. Nothing is filed to a chart until someone presses File to chart.

• Filters: New (received, not yet filed or dismissed; the default), Filed (filed to a chart, not yet reconciled), Reconciled (medications, allergies and problems reviewed) and All (including dismissed files).
• Search: Search sender or patient.
• Each row shows the sending organization, the patient the file is about, the kind of file (Summary of care, Referral note, Care plan, Discharge summary…) and chips: Needs patient, N problems found or No problems, and the status.

Add a file you received another way

Add a health record file adds a file someone gave you on a disk, by download or by email: a .xml, .cda or .ccd file, or a .zip package (each document inside becomes its own row). Files can be up to 15 MB. It needs the permission to import documents. The file then goes through the same check, match and file steps.

Check the file, match the patient, and file it

1. Open the file. The pane shows the sender, the kind of file and when it arrived (in your practice’s time zone). A file that came with a cover message shows the subject, the sender’s secure address, the message, and Also in this message for other attachments.
2. Read the file check. Every file is checked against the health record file rules: No problems found, or This file has N problems — “You can still read it below. Ask the sender for a corrected file if something important is missing.” Show details lists each problem by section in plain words.
3. Confirm the patient. The Patient card puts In the file (name, date of birth, sex, address, phone, their IDs) beside Will be filed to; matching facts get a check mark and differences are highlighted. Hero matches automatically only on an exact name and date of birth with no conflicting sex (Matched automatically); the sender’s record number is never used. Otherwise it lists up to five Possible matches with the reasons (Same name and date of birth, Sex differs) and a Choose button, or use Search for a patient…. Choosing changes nothing yet.
4. Press File to chart. The original file is saved in the patient’s chart documents, and its medications, allergies and problems are read so you can reconcile them. The pane then says “Filed to …. Next: review its medications, allergies and problems against the chart.” and Review & reconcile becomes the main button.

Not for you? Choose Dismiss from the menu and give a reason (Not our patient, Duplicate of a file we have, Sent to us by mistake, or your own). A dismissed file moves to All. A reconciled file can’t be dismissed. Download file saves the original to your computer.

Read a health record section by section

While the feature is on, health record files open as section cards (for example Allergies, Medications, Problems, Results), in the inbox pane and in the chart’s document viewer. The toolbar says how many sections there are.

• Show only this section (the focus icon on a section card) hides the rest; Show all sections or Esc brings them back. On a phone, Go to section… jumps to one.
• Arrange sections lets you move sections up and down and choose what shows when that kind of file opens: All sections, The first section or The first N sections. Save as my default keeps your order for every summary of care (or referral note, or care plan) you open; it is yours only. Reset goes back to each file’s own order.
• Sections the file doesn’t label are always shown last.

Reconcile medications, allergies and problems

After filing, Review & reconcile opens Review and reconcile in three steps: Review, Check final lists, Done. “Nothing changes on the chart until you confirm.”

1. Review each list. Medications, Allergies and intolerances and Problems each show the chart beside the file (In your chart | From … | Decision), with counts such as 3 in chart · 4 incoming · 1 match. Hero pairs the same item by its code (or, for medications and allergies, the exact name). Only current chart items are listed.
2. Decide each row.

   Row	Choices (default first)
   Same item in both	Keep chart, Use incoming (update the chart’s entry with the file’s details), or Stop / Remove / Resolve.
   Only in your chart	Keep, or Stop (medication), Remove (allergy), Resolve (problem).
   New from …	Add (the default when the item is active) or Don't add (the default when it is inactive or resolved).

   A problem from the file that carries no ICD-10 code asks for one when you add or use it (ICD-10 code for the chart), with Hero’s best billable suggestion filled in; the footer counts problems still needing a code.
3. Press Review final lists and read what each list will hold: Added, Updated from …, Kept, Will be stopped / Will be removed / Will be marked resolved, and what you chose not to add.
4. Press Confirm and update chart (Ctrl/⌘+Enter). “The chart is updated” lists what changed on each list.

Only these three lists are reconciled. Everything else in the file (immunizations, results, notes) stays readable in the filed document.

After reconciling, and when something goes wrong

• Lists you can’t apply show View only with the reason, for example “Ask a provider, or staff who reconcile medications, to apply this list.” The file stays under Filed until all three lists have been applied, which can be by different people; it then moves to Reconciled. A reconciled file opens for reference only.
• The updated summary. People who may send health records see View updated summary and Download file on the Done step: a summary of care made from the chart after reconciling, ready to keep or share.