Clinical Fusion^® enables users to enter a variety of registration information. There are very few data requirements in Clinical Fusion^®. The following data elements are contained in the Registration module:

• Demographic: name, sex, race, registration id, registration date, birth date, person telephone numbers, address, and personal numbers (social security, Medicaid, school id, etc.)
• Contact Phone Numbers: contact name, relationship, phone numbers and comments.
• Insurance: company, plan, copay, effective date, termination date, insured’s id, group id, insured’s address, and employment address information.
• Supplementary: referral source, preferred language, family language, housing status, ethnicity, primary provider, marital status, employment status, school, grade, dates of attendance, AKA names.
• Other: other characteristic information about the person.
• Custom: customized data elements

The contact module enables a user to enter any type of contact. Examples include:

• Medical visits
• Well child visits
• Preventative visits
• Mental health visits
• School nurse visits
• Triage visits
• Clinical social worker contacts
• Follow-up visits
• Phone contacts
• Case Management contacts

The following data elements are included in the contact module:

• General: contact date, provider, attending staff member, chief complaint.
• Subjective: a series of subjective questions for different categories (alcohol, nutrition, behavioral, physical activity, etc.), problem risk assessment, and a text box to record notes about each question. This data is used for risk factor reports and to view history assessment information.
• Objective: vital signs including: respiratory rate, pulse rate, blood pressure and temperature; measurements including height, weight, BMI, head circumference, and two user measurement variables; physical exam findings with check boxes to record if an item has been assessed, check boxes to record if a finding is normal or abnormal , note text boxes to record findings.
• Problem List: problem name, additional description, discovery date, onset date, hospitalization dates, resolution status, resolution date, security to set for users to view problems and to enter privacy comments.
• Progress Notes: problem oriented progress notes.
• Plan: medications, tests/orders, procedures, diagnosis codes, problem status, ticklers.
• Custom: customized data elements.
• Closure: provider service time, time in, time out, date signed, disposition, location of contact, confidential contact flag, billable or non-billable contact.
  

CONTACT QUICK ENTRY

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