Clinical Visit Management

A Visit is the core clinical record created each time a patient is seen by a provider. It captures the chief complaint, diagnoses, clinical notes, and links to prescriptions and lab orders generated during the encounter.

Accessing Visits

Go to Visits in the sidebar to see all recorded visits. You can search by patient name, visit code, or date.

Filtering Visits

Filter	Description
Date range	Show visits within a specific period
Doctor / Provider	Filter by the attending provider
Status	Filter by visit completion status
Search	Search by patient name or visit code

Creating a New Visit

Visits are typically created in one of two ways:

From the Queue (Recommended)

Go to Queue.
Find the patient whose status is Waiting or In Progress.
Click Start Visit (or open the patient row and click the visit link).
A new visit is pre-populated with the patient and queue vitals.

From the Visits Page

Go to Visits → New Visit.
Search for and select the Patient.
Fill in the visit details.

Visit Form Fields

Basic Information

Field	Description
Patient	Required — the patient being seen
Doctor / Provider	The attending provider
Visit Date	Defaults to today
Visit Type	Consultation, Follow-up, Emergency, Procedure, etc.
Associated Appointment	Link to an existing appointment (optional)

Chief Complaint

Enter the primary reason the patient is visiting in the Chief Complaint field. This is a free-text field (e.g., "persistent cough for 3 days", "follow-up for hypertension").

Diagnoses

Add one or more diagnoses to the visit:

Click Add Diagnosis.
Search by ICD-10 code or description (autocomplete is available).
Select the matching diagnosis from the suggestions.
Check Primary Diagnosis for the main finding.
Repeat to add secondary diagnoses.

Multiple diagnoses can be added to a single visit. The primary diagnosis is highlighted in reports and summaries.

Clinical Notes

Use the Notes field for SOAP notes, physical examination findings, treatment plans, or any other free-text documentation.

Vitals

If vitals were recorded in the Queue, they are automatically pulled into the visit. You can view and update them here:

Blood Pressure, Heart Rate, Respiratory Rate, Temperature, SpO₂, Height, Weight, BMI.

Follow-up

Set a Follow-up Date if the patient needs to return. This date appears on the visit summary and can trigger follow-up reminders.

Visit Statuses

Status	Meaning
In Progress	Visit is open and being documented
Completed	Documentation is finished; visit is closed
Cancelled	Visit was cancelled or patient left

Provider Sign-off

To finalize a visit, the provider adds a Digital Signature:

Scroll to the Signature section.
Enter the provider name in the signature field.
Click Sign Visit.

Once signed, the visit is timestamped with the provider name and sign time. Signed visits are marked as completed.

Linking Actions to a Visit

From within an open visit, you can directly create linked records:

Action	Result
New Prescription	Creates a prescription linked to this visit
New Lab Order	Creates a lab order linked to this visit
New Referral	Creates a referral linked to this visit
New Invoice	Opens the invoice form pre-linked to this visit

All linked records appear in the patient's profile under their respective tabs.

Viewing Visit History

From the Patient Profile, click the Visits tab to see a chronological list of all past visits. Each entry shows:

Visit code and date
Provider name
Chief complaint summary
Primary diagnosis
Status

Click any visit to open the full record.

Tips

Always link visits to an appointment or queue entry when possible — this creates a clean audit trail.
The ICD-10 search in the Diagnoses field supports both code lookup (e.g., J06.9) and text search (e.g., "upper respiratory").
Set a follow-up date for patients with chronic conditions to ensure they return on schedule.
Visits cannot be deleted to preserve the medical record. If an error was made, edit the visit and document the correction in the notes field.