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IDEXX Cornerstone. Administrator’s Manual (8.3 NEXT version 8.3.6) - page 11

Chapter 16: Setting Up Vital Signs/Weight

** List Value Descriptions

• Body Score (1-5): 1-Emaciated; 2-Thin; 3-Optimal; 4-Overweight; 5-Obese

• Body Score (1-9): 1-Emaciated; 2-Underweight; 3-Slightly Underwt; 4-Ideal - 4; 5-Ideal - 5;

6-Overweight; 7-Moderate Overwt; 8-Signif Overwt; 9-Obese

• Mucous Membranes: White; Pale/Anemic; Pink/Healthy; Red; Blue/Cyanotic

• Capillary Refill: <2 sec; 2-4 sec; >4 sec

• Dental Score: 1-Excellent; 2-Mild; 3-Moderate; 4-Significant; 5-Severe

• Pain Scale: 0-No Visible Pain; 1-Mild Pain; 2-Moderate Pain; 3-Extreme Pain; 4-Major Pain

• Alert/Attitude: 1-BAR; 2-QAR; 3-QAP; 4-Pain, U; 5-Pain, R; 6-Listless

• Appetite: 1-None; 2-Sm Amt w/ Coaxing; 3-Decreased; 4-Normal; 5-Very Hungry; 6-Voracious

• Urine Output: 1-No Urine Output; 2-0%-20% of Normal; 3 - 20%-50% of Norm; 4 - 50%-80% of

Norm;

5-80%-120%: Normal; 6-120%-150%; 7-150%-200%; 8->200% of Norm

• Fecal Output: Profuse, Bloody; Profuse, Watery; Moderate Diarrh; Soft, Dec Vol; Soft, Norm V/C;

Soft, Inc Vol; Mod Constipat; Severe Constip

• Gut Sounds: 0-Absent; 1-Signif Decrease; 2-Mod Decrease; 3-Slow/Present; 4-Normal;

5-Hyperactive; 6-Extremely Hyper

Tip: For Blood Pressure, if you track only the systolic pressure and you want the ability to graph the

values, you could change the type from Alphanumeric to Numeric (where values would be typed as a

single number without a “/” character).

Special Considerations for Body Score:

• There are two default Body Score vital sign options to choose from—one uses a 1-5 scale and

the other uses a 1-9 scale.

• Only one of the Body Score vital sign options can be activated at any given time in your Vital

Sign List. If you try to activate a Body Score vital sign and the other Body Score vital sign is

already active, Cornerstone verifies that you want to reassign the Body Score, and then

automatically inactivates the other Body Score vital sign.

About the Vital Sign List

The Vital Sign List window (Lists > Vital Signs/Weight) displays the name, abbreviation, data type and

active/inactive status of all vital signs that have been set up for your practice.

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Chapter 16: Setting Up Vital Signs/Weight

Using the buttons available on the Vital Sign List window, you can:

• Set up a new vital sign to appear in the practice’s Vital Sign List.

• Update or edit settings for existing vital signs.

• Copy an existing vital sign’s setup and use it as a starting point for creating a new vital sign.

• Delete a vital sign from the practice’s Vital Sign List.

• Set the order of the vital signs displayed on the Vital Signs window at the time of use.

Notes:

• The order of vital signs on the Vital Sign List window does not reflect the order you specify for

the Vital Signs entry and viewing window.

• For Mobile Computing, mobile users can view the Vital Sign List, but cannot perform setup tasks

(add new vital sign, update, copy, delete, etc.).

• For Multi-Location/Single Database configurations, all practices use the same Vital Sign List, but

the order of the vital signs displayed on the Vital Signs entry and viewing window can be

customized for each practice.

Vital Sign Types

If you want to create your own vital signs to use in your practice’s Vital Sign List, think about the way you

want staff members to enter/select values for each vital sign—this will determine the type of vital sign to

select during setup.

Alphanumeric

With an Alphanumeric vital sign, at the time of use the value is typed as letters and/or numbers. Blood

Pressure is an example of an Alphanumeric vital sign.

Example of the Alphanumeric type during setup

Example of an Alphanumeric type entry

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Chapter 16: Setting Up Vital Signs/Weight

Alphanumeric List

With an Alphanumeric List vital sign, at the time of use a value is selected from a list of preconfigured

answers containing letters and/or numbers. Mucous Membranes is an example of an Alphanumeric List

vital sign.

Example of the Alphanumeric List type during setup

Example of the Alphanumeric List type during use

Numeric List

With a Numeric List vital sign, at the time of use a value is selected from a preconfigured list, where the

values are based on a numeric scale with a start value of 0 or 1. You can also simply type the number to

quickly assign the associated value in the list. For example, for the “3-Optimal” Body Score value, you

can simply type “3” instead of selecting the value from the list.

Dental Score is an example of a Numeric List vital sign.

Note: Numeric List vital signs can be graphed.

Example of the Numeric List type during setup

Example of the Numeric List type during use

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Chapter 16: Setting Up Vital Signs/Weight

Numeric

With a Numeric vital sign, you have the option of setting up one or more numeric ranges to serve as a

warning mechanism that alerts you when a value is entered outside the “normal” range for the species.

For example, a Temperature vital sign could be set up to use a range of 95 (low) to 101 (high). If a staff

member accidentally types 966 instead of 96, Cornerstone notifies the staff member that the entry is out

of range and asks the staff member whether to use this value.

Note: Numeric vital signs can be graphed.

Example of the Numeric type during setup

Example of a Numeric type entry

Setting Up the Vital Sign List for Your Practice

Quick-Start Setup—Activating Vital Signs and Assigning Species to Lists

If the default Vital Sign List meets your practice’s needs as is with no customization required, then

consider using the Quick-Start Setup steps. These steps cover the minimum setup required to get up

and running quickly using the default vital signs.

Note: If you plan to edit the default Vital Sign List, add your own vital signs to the list, or set up custom

lists by species or group, do not use the Quick-Start Setup. See “Editing Default Vital Signs or Adding

New Vital Signs” on page 306 for information on standard setup procedures.

To activate vital signs and assign species to lists:

1. On the Lists menu, select Vital Signs/Weight. The Vital Sign List window appears.

2. Double-click a vital sign to edit its settings. The Vital Sign Setup window appears.

3. To activate this vital sign, clear the Inactive check box. (Conversely, to mark it as inactive, select the

Inactive check box.)

Inactive check box in Vital Sign Setup

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Chapter 16: Setting Up Vital Signs/Weight

4. Do one of the following:

• If the vital sign you are activating is an Alphanumeric or Numeric type, no additional setup is

necessary. Click Save to return to the Vital Sign List.

• If the vital sign you are activating is an Alphanumeric List or Numeric List vital sign, proceed to

step 5.

5. To associate one or more species with a list, select the list and then click each desired species to be

associated with it. (Click the species a second time to unlink the species from the list.)

Note: To display this list when adding vital signs for patients, you need to assign the applicable

species to the list here, during vital sign setup. If you do not assign at least one species to the list,

when you try to enter a value for this vital sign, a message displays to remind you that the patient’s

species has not been associated with the list.

Step 1-

select a

list

Step 2-click to select

each species to be

associated with the

list

Associate species with a list

IMPORTANT: Once a list vital sign has been entered for a patient, from that time on, you cannot

add, edit, delete or reorder list values; you cannot change the species associated with the list

(although you can add species to an existing list); and you cannot delete the list. (If necessary, you

can copy the vital sign, inactivate the original version that you copied, then edit the copy as needed

and assign your species as desired.)

6. When you have finished linking all applicable species to a list, click Save to save and return to the

Vital Sign List.

Editing Default Vital Signs or Adding New Vital Signs

To take advantage of the power and flexibility built into the Vital Signs functionality in Cornerstone, you

can customize your practice’s Vital Sign List by doing any of the following:

• Edit the default vital signs

• Add new vital signs

• Add a range of low/high values for one or more species (to have Cornerstone alert staff for

values entered outside the range)

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Chapter 16: Setting Up Vital Signs/Weight

d. If desired, select the Default check box next to one of the list values to designate it as the

default selection. This value will be selected by default in the drop-down list for this vital sign at

the time of use on the Vital Signs window. Note that even if you simply click in the entry cell for

this vital sign on the Vital Signs window, the default value will be selected automatically.

e. To order the list values as you want them to display in the drop-down list, select a list value and

then click the up

or down

arrow button to move the value within the list.

f.

To provide a more detailed description of each list value, select the value in the

Description/Default table and then type the description text (maximum of 500 characters) in the

Extended description box located at the bottom of the window. The extended description will

be accessible on the Vital Signs window at the time of use by clicking the “?” link for that vital

sign.

g. To associate one or more species with the list, select the list and then click each desired

species to be associated with it. (Click the species a second time to unlink the species from the

list.)

Note: To display this list when adding vital signs for patients, you need to assign the applicable

species to the list here, during vital sign setup. If you do not assign at least one species to the

list, when you try to enter a value for this vital sign, a message displays to remind you that the

patient’s species has not been associated with the list.

h. Repeat steps a-g as needed to set up each desired list.

IMPORTANT: Once a list vital sign has been entered for a patient, from that time on, only the

Extended description can be changed. You cannot add, edit, delete or reorder list values; you

cannot change the species associated with the list (although you can add species to an existing

list); and you cannot delete the list. (If necessary, you can copy the vital sign, inactivate the original

version that you copied, then edit the copy as needed and assign your species as desired.)

4.

To delete a list, select it in the List area and click Delete List.

5.

When you are finished, click Save to save and return to the Vital Sign List.

Editing the Weight Vital Sign

As with Numeric vital signs that allow you to set up low/high value ranges, the Weight vital sign can be

edited to add weight ranges appropriate for the species regularly seen in your practice. In addition, you

can specify different units of measure for each range based on species size. For example, you could set

up a range for the Avian species that has the Unit of measure set to grams.

Vital Sign Setup for Weight

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Chapter 16: Setting Up Vital Signs/Weight

To edit the Weight vital sign:

1. On the Lists menu, select Vital Signs/Weight, then double-click the Weight vital sign to edit its

settings.

Note: Basic vital sign settings (Name, Inactive check box, Abbreviation and Type) are predefined for

the Weight vital sign and cannot be changed.

2. If desired, change the number of Decimal Places to be used for recording the weight (applies

across all ranges/species/units of measure).

3. If desired, you can set up weight ranges to alert staff for values entered outside the range. See step

3 in the “To set up a Numeric vital sign (and optionally set up one or more low/high ranges)” section

on page 307 for information on setting up a range.

4. For each range, select a Unit of measure appropriate for the range and the associated species.

5. When you are finished, click Save to save and return to the Vital Sign List.

Setting the Vital Signs Display Order

On the Vital Sign Order setup window, you can specify the order of the rows that display in the Vital

Signs column on the Vital Signs entry and viewing window at the time of use.

Example of Vital Sign Order setup

Example of Vital Sign column during use

Note: You cannot move the Weight vital sign—it is locked at the top (first) position in the list. In addition,

if a Body Score vital sign is activated, it is automatically assigned to the second position in the list.

To set the vital sign display order:

1. On the Lists menu, select Vital Signs/Weight, then click Set Order. The Vital Sign Order window

appears.

2. Multi-Location/Single Database configurations only: If desired, you can customize the vital signs

display order for each practice. In the Practice drop-down list, select the practice for which you want

to set up the vital signs display order.

3. Highlight a vital sign and then use the up

or down

arrow button to move the vital sign to the

desired position in the list. Repeat this process until the vital signs are in the desired order.

4. Multi-Location/Single Database configurations only: If you are setting the order differently for each

practice, repeat steps 2-3 for each practice.

5. When you are finished, click OK.

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Chapter 17: Setting Up Medical Notes and Correspondence

This chapter covers the steps required to set up medical note templates and correspondence

templates in the IDEXX Cornerstone* Practice Management System. For information on adding a

medical note to a patient record or printing a correspondence document, see “Chapter 17: Using

Medical Notes and Correspondence” in the Cornerstone User’s Manual.

Overview

Document templates for both medical notes and correspondence are set up in the Cornerstone Editor.

The Cornerstone Editor provides standard editing and formatting features in a familiar word processing

environment.

Document templates for enhanced medical notes and correspondence can contain elements such as

the following:

• Cornerstone data that is automatically merged with the document using standard bookmarks

• Prompts for situation-specific information using question bookmarks

• Text input fields that can be filled in or “answered” by staff

• Information displayed using design elements such as text boxes, check boxes and tables

• Prompt for inserting patient problem description and details

• Prompt for inserting diagnosis description and details

• Prompt for inserting vital signs information

• Images (e.g., dental chart, eye diagram, etc.)

• Default invoice items

• Signature bookmarks that allow staff members and clients to sign documents electronically

The Cornerstone Editor is used both at the time of setup (when you create or update a document

template) and at the time of use (when you add a medical note to a patient record or print a

correspondence document).

Template Types

When setting up a new template in the Cornerstone Editor, you specify the template type on the

Template Properties dialog box.

Type text box in Template Properties

Template types include:

• Medical Note-Saved in patient history.

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Chapter 17: Setting Up Medical Notes and Correspondence

• Correspondence-Allows you to save to a patient’s history as Title only (saves only the title to

history) or Document (saves entire document to history). Some examples of Correspondence

documents are Consent for Euthanasia Forms or Do Not Resuscitate Orders.

When viewing a patient’s history, you can distinguish the two Correspondence-type documents by

the icon appearing next to the line in history:

Entire Document saved to history

Document Title only saved to history

• Print Only-One-time use documents that are not saved to a patient’s history at the time of use.

Some examples of Print Only documents are Boarding Release Forms or Health Certificates.

Note: Any of the above template types can be created as simple text-only templates. Text-only

templates allow only text-based note entry with no formatting, tables, graphics, check boxes, etc.

The type selected in Template Properties will determine the Type designation for the template on the

Document Template List window.

Template types shown on the Document Template List window

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Chapter 17: Setting Up Medical Notes and Correspondence

Uses for Medical Note Templates

The following table provides brief descriptions and benefits of the various styles of medical note

templates you can create in Cornerstone.

Style of Medical Note

Description

Key Benefits

Enhanced medical note

Allows you to take advantage of the

Apply text styles and formatting, such as

Cornerstone Editor’s full rich-text

font selection, bold, italics, outlining,

feature set to create advanced

numbered/bulleted lists, etc.

medical note documents.

Include check boxes, tables, images, logo

This is the primary style of medical

graphics and electronic signatures.

note that is covered in detail in this

Insert a table of problem details,

chapter.

diagnosis details or vital signs information.

To create: On the Document

Template List, click New and select

Document template.

Text-only medical note

Allows you to use the Cornerstone

You can create and designate a single

Editor in “text-only mode” to create

“Quick Text” text-only template to be used

a simple text-based template (no

to quickly enter a medical note.

formatting or graphical elements).

You can view the full contents of a text-

To create: On the Document

only medical note inline on the Patient

Template List, click New and select

Clipboard* Text tab and Medical Notes

Text only template.

tab without needing to open the note or

use the Preview pane.

Classic medical note

The old medical notes style used in

Classic medical notes are currently the

Cornerstone 7.6 and earlier

only option available for creating

versions.

surgery/anesthesia logs.

See “Chapter 18: Setting Up Classic

Medical Notes” on page 351 for

information.

Enhanced Medical Notes vs. Text-Only Medical Notes-Feature Comparison Table

The following table summarizes the main features and functionality available with the two main styles of

medical notes offered in Cornerstone. Keep these differences in mind when deciding on the style of

template to create.

Enhanced

Text-Only

Feature/Functionality

Medical Notes

Medical Notes

Use a designated Medical Note Quick Text document for immediate

•

text entry, bypassing the Start New Document window steps

Apply a single color to all text using the Color All Text option

•

Apply multiple colors to select words or paragraphs throughout a

•

document

Apply text styles and formatting, such as font selection, bold, italics,

•

outlining, numbered/bulleted lists, etc.

Insert check boxes, tables and other design elements

•

Import graphic files, photos and logos

•

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Chapter 17: Setting Up Medical Notes and Correspondence

Enhanced

Text-Only

Feature/Functionality

Medical Notes

Medical Notes

Add standard text-based bookmarks

•

•

Add image-based bookmarks (bookmarks that include signatures,

•

images, etc. or are inserted in a table format)

Insert a date/time stamp

•

•

Insert a problem description or diagnosis description

•

•

Insert a table of problem details, diagnosis details or vital signs

•

Lock a medical note to create a quick “tab through” form using Text

•

•

Input fields

Use spell check

•

•

Use header/footer features

•

Include attachments

•

•

Include invoice items

•

•

Use options for page setup and margins

•

Email the client directly from the medical note

•

•

Save a document with a Draft, Tentative or Final status and return

•

•

repeatedly to add to or update the document

Void a document

•

•

Add an addendum to a document

•

•

Insert an entire medical note into a correspondence document

•

•

View full contents of the medical note inline on the Patient Clipboard

•

Text tab and Medical Notes tab

View medical note in the Preview pane on the Patient Clipboard

•

•

Uses for Correspondence Templates

Using the Cornerstone Editor, you can create many different types of correspondence document

templates for both internal and external use:

• Referral letters

• Client letters

• Account information letters

• Release/consent forms

• Certificates

• Cage cards

• Breed sheets

• Pet ID cards

• PetDetect* collars

• Patient discharge instructions

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Chapter 17: Setting Up Medical Notes and Correspondence

Step 6-(Optional) Set Up a Signature Capture Device

If desired, you can set up compatible signature capture devices to allow staff members and clients to

sign documents electronically. See “Setting Up a Signature Capture Device” on page 16 for information.

(Note: Electronic signatures are not available with text-only templates.)

Note: You can create an electronic signature for a staff member and store it for later use using the Staff

Information Signature tab (on the Lists menu, select Staff, select a staff member and click Update, and

click the Signature tab). See “Adding Electronic Signatures for Staff” on page 60 for more information.

Cornerstone Editor-Template Setup/Update Window

Properties Banner

Menu Bar

Editor Toolbar

Toolbars

Editor pane

Splitter Bar

Invoice Items

pane

Cornerstone Editor-Template Setup/Update window

Note: When creating a text-only template (versus an enhanced document template), the menus, toolbar

buttons and right-click menus available in the Cornerstone Editor are limited to those options that pertain

to text-based data entry. Throughout this section, those features not available in text-only mode will be

marked with an "(Enhanced templates only)" designation.

Properties Banner (Template Properties)

The information that appears in the Properties Banner is specified in the Template Properties dialog box.

Click the Edit Properties button to access these settings.

Note: The Template Properties dialog box also appears automatically if you click Save for the first time,

if you click OK without first setting the properties, or if you click Save As.

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Chapter 17: Setting Up Medical Notes and Correspondence

Template Properties dialog box

The Template Properties include:

• Name-Type a brief name to identify the template.

• Type-Set the template type as Medical Note, Print Only, or Correspondence.

• Save-If Correspondence is selected as the document type, specify how the document will be

saved. Title only saves only the title in patient history and Document saves the entire document

in patient history so it can be referred to later if needed.

• Show past & future uses of this template…-If you are creating a Correspondence template,

select this check box if you want documents created from this template to show on the Patient

Clipboard Patient History area Medical Notes tab, Daily Planner, Check-in Report and Patient

History Report. (See “Showing Correspondence with Medical Notes in History” on page 341 for

more information on this option.)

• Category-Select a category for the new template. Categories are optional but recommended

for easier searching so you can quickly locate the template later.

• Show in Practice Favorites-Select this check box if you want to flag the template as a Practice

Favorite.

Default Settings (can be changed or added by staff at time of use)

• Hx description-Type a brief description to be used for a document created from this template.

This is the description that is recorded in the patient’s medical history.

• Hx Alert-Select this check box if you want medical notes created from this template to stand

out in history (line displays in history as white text on a bright red background).

• Autofinalize in __ days-If you want medical notes created from this template to automatically

finalize at End of Day after a certain number of days, select the Autofinalize in check box and

enter the number of days. This default can be set in Documents defaults (see “Documents

Defaults” on page 100).

• Printer-Select a default printer for printing documents created from this template. If documents

created from this template should print to a specific printer (different from the printer selected in

Printer Setup), select it here.

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Chapter 17: Setting Up Medical Notes and Correspondence

Editor Menu Bar

The Editor menu bar includes the File, Edit, View, Insert, Font, Paragraph, Table and Other menus. (The

menu bar is located within the Cornerstone Editor window, separate from the main Cornerstone menus.)

Note: When using the Cornerstone Editor in text-only mode, the menu options available are limited to

those options that pertain to text-based data entry.

Editor Toolbar

The Editor toolbar buttons provide quick access to commonly used functions within the Cornerstone

Editor. (The Editor toolbar is located within the Cornerstone Editor window, separate from the main

Cornerstone toolbar.)

Print preview

Cut

Picture

Print

Copy

Table

Send email

Paste

Spell check

Client signature^†

Select all

Zoom

Undo

Search

Insert date and time

Redo

Bookmark

Lock/Unlock document

† Not available during template setup; available only at the time of use.

Note: When using the Cornerstone Editor in text-only mode, the toolbar buttons available are limited to

those options that pertain to text-based data entry. text-only mode also offers a Color All Text

button that allows you to apply a single color to all text in the template or document.

Toolbars

(Enhanced templates only)

The toolbars include options for frequently used document elements, display settings, style settings and

formatting tools. The toolbar can be turned on/off using the View menu > Tool Bars option.

Insert date/time, page number or number of pages,

and show/hide non-printing characters such as

returns, tabs and spaces

Specify the magnification level for viewing the current

template

Set the paragraph style, font, font size and effect of

selected text (bold, italics, underline)

Set the justification of the paragraph (align left, center,

align right, justify)

Format selected text as a numbered/bulleted list,

increase/decrease the indent, and set the text color

Editor Pane

The Editor pane is the template “page” where you add your desired text, pictures, tables and other

elements. You can add elements within the Editor pane area using the menu bar, Editor toolbar or right-

click menu.

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Chapter 17: Setting Up Medical Notes and Correspondence

Splitter Bar

You can drag the adjustable splitter bar up or down to increase or decrease the visible area of the Editor

pane and Invoice Items pane. While editing a template, in most cases you would want the splitter bar at

a lower position so that more editing space is available in the Editor pane. If you need to work in the

Invoice Items pane, simply drag the splitter bar upward as needed to increase the working area of the

Invoice Items pane while you are inserting or editing the template’s default items.

Invoice Items Pane

You can easily add default invoice items to a template using the Invoice Items pane located at the

bottom of the Cornerstone Editor window. In the Cornerstone Editor, all invoice items reside in the

Invoice Items pane, not in the body text of the template.

IMPORTANT: Default invoice items cannot be placed on a template designated as a special action that

prints after an invoice is posted.

Notes:

• The Invoice Items pane does not display for Print Only templates.

• If you are converting from Classic to enhanced medical notes, note that both Consult items and

invoice items from the Classic template are transferred to the Invoice Items pane in the

enhanced template and marked as Accepted.

To add default invoice items to a document template:

1. In the Invoice Items pane, double-click or press F2 in any blank Item ID row to open the Invoice Item

list, allowing you to search for and select the desired item. An empty “add item” row always appears

below the existing item rows.

2. After adding an item, you can use the

and arrow buttons to rearrange the order of the item

lines as needed. (Note: You cannot rearrange the order of item lines that are part of a group code.)

3. You can also change the item status by clicking on the gray box to the left of each item row. Item

status options during template setup include:

Blank-An item assigned a Blank status can be thought of as “sitting dormant” until you decide

to utilize it, which means it will not be sent to the Patient Visit List. In some cases, you may want to

add items to the template with a Blank status and let the staff member decide at the time of use

whether to change the status.

Recommended-This item or service has been recommended for purchase by the client.

Accepted-The client has accepted the item (wants to purchase the service or item).

Performed-The item has been dispensed or the service has been performed.

Note: The Declined or Declined to history statuses are not available when setting up default invoice

items in the template.

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Chapter 17: Setting Up Medical Notes and Correspondence

Page Setup and Formatting Tools

Tip: For a list of keyboard shortcuts available for use in the Cornerstone Editor, see “Chapter 17: Using

Medical Notes and Correspondence” in the Cornerstone User’s Manual.

Ruler Bars

Select View > Horizontal Ruler or Vertical Ruler to turn on/off the ruler display. The horizontal ruler

includes indicators for indent settings and tab stops, and allows you to quickly change these settings

directly on the ruler. The vertical ruler includes a tab selector icon

that you can click to change the

tab type.

Left indent

Tab selector

Horizontal ruler

indicator

Tab indicator

Right indent

Hanging indent

indicator

indicator

Vertical ruler

See the “Tab Stops” section that follows for information on setting tab stops on the ruler.

Page Setup Options

(Enhanced templates only)

Use File > Page Setup to set up options such as columns, text flow direction, page orientation (Portrait

or Landscape), paper size, and paper source.

Section Parameters dialog box

Tab Stops

The Cornerstone Editor supports left, right, center and decimal tab stops. The tab stops can be set for

the current paragraph or all lines in a highlighted block of text.

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Chapter 17: Setting Up Medical Notes and Correspondence

To set/clear tab stops using the rulers:

Tip: To easily set the tab type and add tab stops directly on the rulers, you will need to display both the

horizontal and vertical rulers (the tab selector icon

appears at the top of the vertical ruler only when

both rulers are displayed).

To add this type of tab

Do this

Left tab

Click the left mouse button on the ruler at the desired location

OR

Click the tab selector until it shows

and then click the left mouse button on the

ruler at the desired location

Right tab

Click the right mouse button on the ruler at the desired location

OR

Click the tab selector until it shows

and then click the left mouse button on the

ruler at the desired location

Center tab

Hold the SHIFT key, and click the left mouse button on the ruler at the desired

location

OR

Click the tab selector until it shows

and then click the left mouse button on the

ruler at the desired location

Decimal tab

Hold the SHIFT key, and click the right mouse button on the ruler at the desired

location

OR

Click the tab selector until it shows

and then click the left mouse button on the

ruler at the desired location

To move a tab stop using the rulers:

¾ On the ruler, click on the tab indicator and drag it to the desired location on the ruler.

To clear a tab stop using the rulers:

¾ On the ruler, click on the tab indicator and drag it downward off the ruler.

To set tab stops using the Paragraph menu:

1. On the Paragraph menu, select Set Tab. The Set a Tab Position dialog box appears.

Set a Tab Position dialog box

2. Specify the Tab Type (left, right, center, decimal).

3. If desired, select a Tab Leader (dot, hyphen, or underline).

4. Click OK.

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Chapter 17: Setting Up Medical Notes and Correspondence

To clear tab stops using the Paragraph menu:

¾ On the Paragraph menu, select Clear All Tabs.

Page Margins

(Enhanced templates/documents only)

Use File > Page Margins or set as you go by moving the margin indicators on the horizontal ruler

(select View > Horizontal Ruler to turn on/off the ruler display).

Page Margins dialog box

Document Template Setup Tools

Header/Footer

Tables

Bookmarks

Text Input Text

Check Boxes

Problem Prompts

Diagnosis Prompts

Vital Signs Prompt

Cornerstone Editor-Document Template Setup Tools

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Chapter 17: Setting Up Medical Notes and Correspondence

Select Bookmark dialog box

Note: If you convert a Classic medical note to an enhanced medical note, any data fields that were

contained in the Classic medical note will convert to Question bookmarks in the enhanced medical note.

See “Conversion of Existing Data Fields in Classic Template” on page 344 for more information.

Important Guidelines for Inserting Bookmarks

• When adding multiple bookmarks in succession, always add a space between the bookmarks

to separate them and avoid placement issues later (you cannot click between two touching

bookmarks and insert text or punctuation).

• Any bookmarks that are copied from one template and pasted into another template will lose

their functionality and these bookmarks will not work (if pasted into another document

template they will display normally, but they will not function). To reuse bookmarks you must

either use the Document Template List Copy button to create a copy of the template containing

the bookmarks or use Save As to save the template with a different name.

• Depending on their intended use, Question bookmarks added in previous versions of

correspondence may better suit your needs as Text Input Fields. They can be easily identified

within a document and can be filled in at any time while completing the document. See

“Inserting Text Input Fields” on page 330 for more information.

• When adding bookmarks to a text-only template, only text-based bookmarks can be used

(image- or table-based bookmarks are not available for selection).

To insert a bookmark in a document template:

Note: See the “Cornerstone Bookmarks Available for Use in the Cornerstone Editor” section that follows

for information on the bookmarks available when creating a document template in the Cornerstone

Editor. This section also includes information on specific steps required to set up special types of

bookmarks (Medical Notes, Question, Vaccination and Signature bookmarks).

1. Right-click in the document template where you want to insert a bookmark and select Insert >

Bookmark. Alternatively, you can click the Bookmark

button on the editor toolbar or select

Bookmark from the Insert menu. The Select Bookmark dialog box appears.

Note: The right-click option is not available when inserting a bookmark within a table.

Select Bookmark dialog box

2. In the File Description drop-down list, select the type of Cornerstone file to use to create the

bookmark (e.g., Client, Invoice Items, Patient, etc.).

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Chapter 17: Setting Up Medical Notes and Correspondence

Lab

These bookmarks can be used only if your practice has purchased the Laboratory module.

Lab results

Medical History

Abnormal exam observations only All exam observations

Departing instructions

Patient diagnosis

Medical Notes

If desired, medical notes can be inserted into a document template (typically a correspondence

template) using a Medical Notes bookmark.

Medical Notes bookmark

IMPORTANT: When selecting the medical notes to include in the template, note the save status of

the document (Draft, Tentative or Final). This save status is important to note, as you would not want

to include a Draft medical note in a referral letter or client handout.

Note: The option to display only part of a medical note in correspondence applies only with Classic

medical notes. You cannot include part of a medical note in a correspondence document with

enhanced medical notes; with enhanced medical notes the entire document is included. You can

then select and delete any included content that is not applicable.

Miscellaneous

Current Date

Patient (Includes Rabies Tag)

Age

Current Weight Unit

Number of Years

Sex

Birth Date

Current Weight Unit Date

Patient Classification

Species

Breed

Date Current Weight

Patient ID

Vaccine Amount

Check In Date (last)

Date Patient Entered

Patient Note

Vaccine Expiration

Check In Time (last)

Deceased Date

Patient Status

Vaccine Lot Number

Check Out Date (last)

Manner of Injection

Rabies Expiration Date

Vaccine Name

Check Out Time (last)

Markings

Rabies Tag Date

Vaccine Producer

Color

Microchip ID

Rabies Tag Number

Vaccine Type

Current Weight

Name

Registration Number

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Chapter 17: Setting Up Medical Notes and Correspondence

Practice

All Phones

Clinic City

Clinic Name 2

Clinic Postal Code

Clinic Address 1

Clinic Name

Clinic Phone

Clinic State

Clinic Address 2

Prescription Instructions

Choose any prescription instruction from the Prescription Instruction List.

Question

You can use Question bookmarks to prompt staff to answer questions when the document is added

to a patient’s record at the time of use.

Cornerstone uses the text you enter for your merge question as the name of the question bookmark

that appears in the document template. If desired, you can change the name of the bookmark to

make it more meaningful. A bookmark can be up to 40 characters with no spaces.

Question bookmark

When you select a document template at the time of use, the document opens in the Cornerstone

Editor and you are immediately prompted to answer all of the questions (Question bookmark

prompts) in that document. The questions are asked in the order they appear in the document.

The answer you type is printed in the document. To leave a question unanswered in the document,

type a space or simply click Cancel.

Referral Doctor

All Phones

Ref. Doctor Last Name

Ref. Doctor Postal Code

Ref. Doctor Address 1

Ref. Doctor City

Ref. Doctor State

Ref. Doctor Address 2

Ref. Doctor Email

Ref. Doctor Title

Ref. Doctor First Name

Ref. Doctor Fax

Ref. Doctor Phone Number

Ref. Doctor Full Name

Ref. Doctor License

Ref. Doctor Phone Desc.

Ref. Doctor Phone Extension

Referral Hospital

All Phones

Ref. Hospital City

Ref. Hospital Fax

Ref. Hospital Postal Code

Ref. Hospital Address 1

Ref. Hospital Email

Ref. Hospital Name

Ref. Hospital State

Ref. Hospital Address 2

Ref. Hospital Phone Number Ref. Hospital Phone Desc. Ref. Hospital Phone Extension

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Chapter 17: Setting Up Medical Notes and Correspondence

Reminder Info

After you select the Invoice Item, the Reminder Information choices display. Specify whether you

want to enter the Description-Reminder Due, Description-Reminder Given, Given Date, Due Date or

Use Pattern.

Staff

All Phones

Staff Extension

Staff License Number

Staff Postal Code

Staff Address 1

Staff First Name

Staff Middle Initial

Staff State

Staff Address 2

Staff Full Name

Staff Note

Staff Status

Staff City

Staff ID

Staff Phone Description

Staff Title

Staff Classification

Staff Last Name

Staff Phone Number

Signature

Signature w/Pwd

Note: In order to use a Staff Signature bookmark (or a Signature w/Pwd bookmark), you must first

set up your system to use a supported signature capture device. See “Setting Up a Signature

Capture Device” on page 16 for more information.

User-Defined Client and Patient Prompts

You can place the answer to a client or patient prompt in the document. The client or patient

prompts that appear as field descriptions are the same prompts that are currently set up in

Cornerstone.

Vaccinations

Vaccinations work in the same way as reminder information. Using vaccination bookmarks

(Description - Reminder Due, Description-Reminder Given, Given Date, Due Date), you can create

health and vaccination certificates.

Before inserting vaccination bookmarks in a template, you must first set up your Vaccination

Bookmarks defaults (see “Vaccination Bookmarks Defaults” on page 138).

After vaccination preferences and pattern have been selected, bookmarks for the selected

vaccinations can be included in documents. To include vaccination preferences in a document,

select the Use preferences check box when setting up the bookmark.

Vaccinations bookmark

When documents with the bookmarks are printed, the bookmarks are replaced by vaccination

information from the selected patient’s record.

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Chapter 17: Setting Up Medical Notes and Correspondence

Inserting Text Input Fields

When setting up a document template, you can insert Text Input Fields that allow you to create preset

form fields. These fields can be filled in or “answered” by the staff member at the time the medical note

or correspondence document is added for a patient.

Tip: All Text Input Fields display with a light gray background so they are easily identified at a glance

within the document.

Input Field Parameters dialog box

Once the Text Input Fields are set up, you then have the option of locking the document so that at the

time of use the staff member can easily tab from field to field to fill in the patient-specific data or accept

the default data.

Tips for Inserting Text Input Fields:

• If it is a patient-specific field and does not have a commonly used answer, you may want to

enter a prompt as the Initial Data placeholder text (e.g., [enter Hx here]). If the field needs to be

limited to a small number of characters, you may want to enter XX or something similar (e.g., if

the answer needs to be a 2-digit number, you could enter ## for the Initial Data).

• If your default data (Initial Data) is a paragraph of text, you can insert a placeholder word in the

Initial Data box in the Input Field Parameters dialog box. Then, after clicking OK to create the

field, you can click within it and add additional text or copy/paste text into the field.

• For some form fields where the “answer” is a choice between two or three possible answers,

you may want to insert all possible answers as the Initial Data. At the time of use, the staff

member can leave the chosen answer and delete the unwanted answers. For example, if the

answer is either Left or Right, use “Left/Right” as the Initial Data, and, at time of use, instead of

typing one or the other, you can simply delete the unwanted one.

To insert a Text Input Field in a document template:

1. When setting up or updating a document template, in the Cornerstone Editor, right-click and select

Insert > Text Input Field. The Input Field Parameters dialog box appears.

Input Field Parameters dialog box

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Chapter 17: Setting Up Medical Notes and Correspondence

2. In the Field Name box, type a name by which to identify this field.

3. In the Initial Data box, type the default “answer” text to appear in the field. In most cases, you would

want to enter the most commonly used answer so that, at the time of use, the staff member can

simply press TAB to accept the default data and move to the next field.

Note: If you do not provide Initial Data to serve as the placeholder text, the document will display

underscore characters “__” for this field at the time of use.

4. In the Maximum Field Length box, type the maximum number of characters to accept in this field.

Tip: In many cases you may want to leave the Maximum Field Length blank to allow text entry in

the template at the time of use.

5. If you want to specify a particular font for the field (e.g., a font that stands out from the other text on

the page), click the Font button to select a font, style, size, color and effects.

6. Click OK.

7. When you are finished with the template setup, if you want to “lock” the document to allow for quick

tab-through data entry at the time of use, click the Lock/Unlock document

button.

Note: The Lock/Unlock setting can be turned on or off at use time if desired.

Inserting Check Boxes

(Enhanced templates only)

You can easily insert a check box that changes state when

clicked—click once to place a check mark in the box, click

again to clear the check mark.

To insert a check box:

¾ Right-click within the editor pane and select Insert >

Check Box. The check box is added at the current cursor

location.

Tip: To get check boxes to line up nicely into straight vertical

columns, use a fixed-size font (e.g., Courier, Lucida Console,

etc.) or use tabs.

Inserting Tables

(Enhanced templates only)

The Cornerstone Editor makes it easy to add simple or complex tables.

Tables can be used to organize or group categories of information within a

document, or can be used to provide a cleaner layout for content-heavy

documents.

The standard Table option inserts a simple table based on the number of

rows and columns you specify. You can then right-click within the table to

insert rows or columns, or to apply formatting like borders and shading. You

can also use the Table menu options to apply detailed table formatting

options for cell positioning, flow, color, rotation, etc.

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