Flow Sheet: Working with the Flow Sheet

  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.

Working with the Flow Sheet

Once you have your flow sheet set up you should see a flow sheet with a single visit on it as seen below:

The first visit or two are always the most time-consuming in terms of getting things set up. Once the flow sheet is established you will see an overall savings in the amount of time it takes to document your patient, as all of your settings will carry forward from visit to visit.

On this particular flow sheet you will notice that the first function is an Initial Evaluation. Putting an evaluation function on the flow sheet is optional, but in this chapter, we are going to show how to take advantage of the flow sheet to do all of your charges. (You do have the option of doing your charges from the Charges and Documentation screen, but we recommend doing everything from the flow sheet.) At the beginning of your first visit, you may only have an Initial Evaluation function on your flow sheet and will probably add the other functions after the evaluation is complete or during the patient’s second visit. Simply, for example, we have set up the flow sheet before we have seen the patient for the first visit.

Once the functions are on the flow sheet there are a few more steps that have to be completed. We need to associate each function with diagnosis codes, and goals from the evaluation and set any parameters that need to be set.

To perform these steps you can double click on the function or right-click and select ‘Edit Function’.

Below is an example function - HVG (High Volt Galvanic Stimulation):

The top portion of the screen shows the function. The check box in the top right of the function portion indicates that it has been performed that day. All of the function’s parameters are listed under the function name. For more detail on the various function parameters see the section of this chapter on Creating Functions.

Below the function is the diagnoses list showing all of the diagnoses that are currently active in the case. Checking the checkboxes will associate this function with those diagnoses. This is important as it ultimately allows the system to know which diagnoses go with which charge codes.

The very last section shows the goals associated with this function. The goals listed here are pulled from all of your signed Treatment Evaluations.

NOTE: If the goals do not appear, either there is not a signed evaluation, or the evaluation is not classified as a Treatment Evaluation.

All of this information will carry over from visit to visit, so you will not have to do this for each visit. You will only have to update anything that may have changed since the last visit.

When you return to your flow sheet you will notice that the function is now "lit up" and has a green check indicating that it was performed for that day.

You would continue to set up your flow sheet and set the various parameters for each function. If you forget to associate goals or diagnoses with your function then the function will appear with a cross-hatch pattern as shown on the Piriformis Stretch below:

On the Flow Sheet itself, you can click the to mark the function as being completed. The box allows you to expand or collapse the functions, hiding the parameters. Below is a fully collapsed flow sheet:

Right-Clicking on the Flow Sheet gives the following options:

Flow Sheet

Expand All	Expands all functions.
Collapse All	Collapses all function.
Edit Function…	Displays the Edit Function screen and allows you to enter parameters, set diagnoses, and link goals. Double clicking the function also displays the Edit Function screen.
Edit Flow Sheet…	Brings up the flow sheet editor allowing you to add, remove, hide or alter the order of the functions on your flow sheet.
Edit Flow Sheet Reminder…	Allows you to set the Flow Sheet Reminder note shown at the bottom of the flow sheet.
Rename Flow Sheet…	Allows you to set the name of this flow sheet. Typically only used in the case of multiple flow sheets for a patient, which is covered towards the end of this chapter.
Set Timing Algorithm…	Allows you to select the Direct Contact Time to Units calculation algorithm. Default is Medicare’s Rule of 8’s. More information on the algorithms can be found in the last section of this chapter. USE ALTERNATE TIMING ALGORITHMS AT YOUR OWN RISK. FUSION ENTERPRISE NEITHER APPROVES NOR DISAPPROVES OF THESE METHODS AND SHOULD BE USED IN ACCORDANCE WITH ANY RULES, LAWS, OR CONTRACTS IN PLACE FOR YOUR COMPANY. This function may or may not be available in your system depending on your settings. By default, the timing algorithm is set in the Carriers area.
Set Exercise Goals…	Allows you to set functions for all goals at one time. This is quicker than opening up each one individually. See the section titled Other Functions for more information on this feature.
Set Color…	Allows you to set the color of the function. Useful for internal notation. See the section titled Other Functions for more information on this feature.
Daily Note ->
-> New Note…	Creates a new Daily Note, filling in objective text from the flow sheet.
-> New Note Flow Forward…	Creates a new Daily Note pulling information from the previous Daily Note and merging it with the new objective text.
-> Open Note…	Opens the Daily Note associated with the selected visit.
-> Delete Note…	Deletes the daily note created from this flow sheet. This allows you to then modify your flow sheet and create another daily note.
Open Claim Based Reporting…	Opens the Claim Based Reporting module for PQRS and Functional Limitation Reporting.
Validate Charges…	Takes the currently selected functions and derives a charge code set, processes them through the charge validation system, and displays the results at the bottom of the screen.
Post / Reset Charges…	Once your note requirements have been met you can Post your charges. If you need to make changes once you have posted charges you can reset them which will delete the charges. You would then Post the charges again once your changes have been made.
Delete Flow Sheet Visit…	Deletes the flow sheet from the selected visit.
Delete Flow Sheet…	Deletes the entire flow sheet.
Deactivate Flow Sheet…	Deactivates the flow sheet allowing you to create a new flow sheet. More on this later in the chapter. Note that a visit can only appear on ONE flow sheet.
Magnification…	Allows you to set the magnification level of the flow sheet. Zoom in or out to suit your preferences.
Show Function ID’s	Displays the unique function ID next to the function. This is useful when looking at two functions with the same name.
Show CPT’s	Displays the CPT code connected to the function.
Open Case	Opens the Patient Case screen.
Report ->
-> Therapist	Displays a printable report of the Flow Sheet with the functions that are not marked as performed visible.
-> Carrier	Displays a printable report of the Flow Sheet with the functions that are not marked as performed hidden.
Close	Closes the Flow Sheet.