Flow Sheet: Display (Fusion Enterprise)

  Permissions! Clinic Staff must have Administrator, Clinical Director, PTA, Staff Therapist, Therapy Student, or Therapy Technician assigned in order to manage some of the features of the Flow Sheet.

Fusion Enterprise understands that managing all of your cases is a critical function of any practice. We have created Fusion Enterprise to not only be easy to use, but also allow any therapist to be able to sit down and with very little instruction be able to complete an evaluation or a daily note. We have designed the actual documentation to be as customizable as possible. This series of introductory articles will cover the essential aspects of the Flow Sheet in Fusion Enterprise.

Display

Much like a paper flow sheet the electronic counterpart has a column for each patient visit. Unlike the paper equivalent, the current visit is always shown on the far left with other visits appearing on the right in a scrollable list. Also unlike the paper equivalent, this flow sheet offers the luxury of automatically copying what you did on the previous visit forward to the current visit, as well as enabling reorganization of your flow sheet at any time.

The above screenshot shows a sample flow sheet that is displaying 4 visits. The visit that is selected is displayed in the leftmost column with the older visits shown to the right. Each individual box is a function that may or may not have been performed for a given visit. Functions that were performed for a particular visit show up as a lighter color than those not performed.

Let’s further break down each of the parts of the flow sheet. At the top of each visit is the header:

The visit header contains the following information:

Header

Visit	The currently selected visit. The drop-down allows you to select other visits.
N Icon	Indicates whether you have created a daily note. The icon may be Red, Orange, or Green which represents Not Done, Started But Not Signed, and Completed.
C Icon	Indicates whether you have posted charges from the flow sheet for this visit. The icon may be Red or Green which represents Not Done, and Completed.
B Icon	Indicates that a visit has been Billed. The icon may be Red or Green which indicates a claim has been sent.
Therapist Name	Therapist that treated the patient.
Left / Right Arrows	Allow you to scroll through the visits on the right side of the screen.

The functions themselves appear in individual boxes. Below we see 4 functions, Hamstring Stretch, Piriformis Stretch, Hip Adductor Stretch and Resisted Hip ER.

Each of these has a number of parameters. For example, Piriformis Stretch has DCT (Direct Contact Time), Sets, Reps, Activity Time, Hold and Body Postion. FUSION ENTERPRISE comes with hundreds of functions, but you also have the ability to create your own and can define the parameters you wish to record. If a function parameter value has changed since the previous visit the parameter text will be shown in blue.

The bottom of the flow sheet is divided into two parts: the left part pertains to time, and the right part is a set of tabs.

The Time portion is displayed on the lower left of the flow sheet

These fields are defined as follows:

Time

In / Out	The initial values are pulled from the schedule. The therapist can alter these to more accurately reflect the patient’s true time in the clinic. Note that this does NOT change the appointment times on the schedule. Clicking on the ‘Clock’ button sets the time to the current time.
Total	Number of minutes between In and Out.
DCT	Shows total direct contact time as entered into the various functions.
BU	Shows the number of Billable Units based on the DCT. (See the section on Alternate Timing Algorithm on how this is calculated)
PoS	The default Place of Service.    Populates with the default PoS of the clinic where the patient was treated. It can be overridden if needed but is typically left as the default.

The bottom area has 5 tabs:

The Flow Sheet Reminder is a free-form note for the therapist. There is one Flow Sheet Reminder note for the entire flow sheet. This can be used to make important treatment reminders or convey information to another therapist that may treat your patient at a later date.

The Patient Info tab has the following fields:

Patient Info

Appointment Type	Type of appointment as assigned on the schedule.
Account Type	Account Type as assigned in the patient case.
Service Type	Service Type as assigned in the patient case.
Last Eval	Date of last evaluation as well as the number of days and visits since it occurred.
Visit Limit (Ap/Att/Rem)	Visit limit as defined in the General Info section of the patient case. Approved, Attended, Remaining.
Checked In	Indicates if the visit has been checked in on the schedule. Daily Note or Charges may not be created for a visit until it has been checked in.
Referring Doctor	Referring Doctor as assigned in the patient case.
Script	Script Date and Frequency as defined in the patient case.
Clinic	Clinic at which this visit occurred.
Doc Status	Displays which notes are required or missing.
Compliance Enforcement	Indicates if the system is set to enforce compliance.
Timing Algo	The timing algorithm that will be/was used to compute charges for this visit. Note the default is CMS Rule of Eights.

The Objective tab shows the objective part of the daily note. This is automatically created as you mark various functions as being performed.

After you click Validate Charges in the right-click menu, the Charges tab shows a list of charge codes, as well as any validation messages. In the case of a failed validation (such as LCD List violation) then the validation message will be shown.

The shortcut tab is buttons that link to some of the functions of the right-click menu. These are more tablet and touch-friendly.

Directly above the tabs is a slide-up alert bar to alert the therapist when Progress Notes and Functional Limitation Reporting are due.