The booking form and the operation note
From the case on a list, or from the patient's operations.
The date at the top of a booking form on a list opens that day's operating list, as Operating list does. Move, beside it, opens the list with the choice of another list ready, and puts the case on the one chosen in a single step.
Operating list, at the top of a booking form on a list, opens the list in a window over the form for a quick look; Close or Escape takes you back to the form where you were, and Open goes to the full list.
The deposit line on the booking form says which of four is true: paid, and when; asked, and when; held for decision; or could not be asked, and why. Where a Director has decided that no deposit is asked for, the line says so and gives the reason recorded with that decision, for example that the patient has already paid it to another account and it is waiting to be passed to the hospital. Where the payments on the booking's invoice already cover the deposit, it says Paid, and the Deposit box below is set to Paid so the two agree, as the booking opens and in the morning check for every booking still to come; a booking marked Not required is left as it is. A deposit is asked for only to confirm a surgery date, so an operation with no date is never asked, whichever button is pressed. No longer provisional asks for the deposit by itself, once; Request deposit asks at any time, and Send again repeats it. A booking held for decision is one from before the deposit moved to the hospital: a Director either presses Request deposit, which asks, or Don't ask. Every morning a check asks for any self-pay booking off Provisional, with a future date and no deposit asked for, that has been missed, however it came off Provisional; it never asks twice, never where the deposit shows as paid or not required, and never on an insured or cancelled case, and where it cannot ask it gives the booking's coordinators a task saying why. The patient is emailed and pays in their portal, and the payment is recorded on the hospital's invoice. Where the surgery booking confirmation is switched on and has not yet gone for the booking, the deposit is asked for in that email instead of one of its own; Request deposit still sends its own email at once. When an operation with a paid deposit is cancelled, the line asks for the day it was cancelled and the costs incurred, says what the terms return and keep and any part owed to the surgeon's practice, and Record keeps the outcome: a task asks the hospital's payers to return the amount to the patient, and the practice's part is raised to be paid. Nothing is refunded by itself. A booking held for a decision, where the decision is to ask but there is no invoice yet, says To ask once invoiced: the request goes by itself within the hour of a self-pay invoice being linked, and never before. Beside it, the patient's portal status shows, with Invite where they are not on it yet; the first press of Invite shows, in a box under the line, anything outstanding, what their portal will show, one step to a line, and where the invitation goes, and the second sends it.
Add to a list, at the top of a booking form with no date, shows the coming operating lists of every organisation you sign in at. Press Add here on one and the case goes on it; the booking form is the same one, not a copy. Once it has a date, the date opens that day's list.
Cancel operation, at the top of the booking form, cancels it. Choose the reason and add a note, then press Cancel the operation: it comes off its operating list, the cases below it move up, and the reason and the note go on the operation and its log. The patient is not told by this; write to them from their record. A cancelled operation shows Cancelled under the name and Reschedule where Cancel operation was: press it to see the operating lists, choose a future list and press Add here, and it is back on.
The booking form is everything about the operation before the day. The operation note is the clinical record of what was done: apply one or more templates, write the note, and answer each data point the templates ask for. A case pressed on the schedule opens the booking form while the day of surgery is still ahead, and the operation note on the day and after it; each page has a link to the other at the top, so both are always a press away.
The operation note is laid out in three columns. On the left a list of its sections in the order they are written, each with a dot: green when everything in it is recorded, amber when part is, grey when nothing is yet. A data collection point with nothing on it reads not recorded on its folded line, and the Sign card names each such point with its stage, so the one keeping a dot amber can be found; signing does not wait for them. Pressing a section goes to it, and the list marks the one you are reading as you scroll; on a narrower screen it becomes a strip above the note. In the middle are the sections themselves: Details, Preoperative, Intraoperative, Note, Implants, Postoperative, Instructions and Sign. Implants is there only for an operation that has implants ordered or recorded. On the right, folded, are the running order and who was present (both open to begin with), the photographs, the letters and the payment position, which are read rather than written.
Running order, at the top of the right-hand column, is the operating list this operation is on: its day and theatre, and every case on it numbered by its place, with this operation marked. Pressing another case's name opens that operation's note. Its line says where this operation comes, such as 2nd of 4. Up and Down beside a case move it one place, and the admission and start times of the cases follow, exactly as moving it on the operating list itself does; the new order is the one the list, its printed sheet and the schedule on Start show. Only the list's surgeon, its people and those who schedule lists can move a case, and not once the list has happened or been cancelled. Where the list is not yours to see, the card says only where this operation comes.
A case whose admission or start time does not fit the list's own start time is marked in amber under its name, with the time the list suggests, and a line above the cases says how many are out of step. Use suggested times, offered to the same people as Up and Down, sets them all to the suggested times, keeping the order, exactly as it does on the operating list.
A strip of steps runs across the top of the booking form and stays there as you scroll: one for each part, green once that part is confirmed, and at the end either how many things are still to do or Ready to submit. Press any of them to jump to that part. The same list spelled out in full, one line per thing outstanding, is under Submit at the foot of the form.
Operation, under Details, is the name of what was done. Until somebody types one it is read off the procedure lines on the invoice. Change it and it is saved as you leave the box, and the patient's record, the timeline and the booking form all show the new name. Empty the box to go back to the invoice's wording. A locked note shows it read-only.
Knife to skin and the procedure end are written as soon as you leave the box, with Saved beside them, so neither can be lost by reloading the page or pressing something else. Now stamps the time it is pressed. Applying a template does not touch them. Where the theatre team pressed knife to skin or the procedure end on the theatre timings, those times take precedence: they are shown in the boxes in place of whatever the note held, the line beneath says what the note held, and they are not on the note yet until you press Keep these times or change one of them, when both are written.
A data collection point can be taken off the note: Remove sits beside its box, and it asks first and says what is recorded on it, because what comes off has to be typed again rather than brought back. A note that holds the same point twice, which happens where two notes were merged, says so above the stages and takes off in one press every copy that adds nothing: the empty ones, and the ones repeating an answer already recorded. Where two copies hold different answers it leaves them and says so, because which one is right is for you to read.
The Log at the foot of the booking form lists what has been done to the case, newest first, and takes an entry by hand in the same way a contact's log does: write it, choose a file to go with it if there is one, and press Add entry. The entry carries your name and appears on the patient's own log as well. Remove beside a file takes the file off, on a second press, and leaves the entry's words where they are.
Under Procedures and costs, each invoice on the case is listed by its number, and the number opens the invoice itself, with Back returning to the form. Beneath the number, each procedure is listed with any variant billed on it after a plus, such as Brachioplasty + RF Ignite/Quantum Cannula, so it is clear that Quantum is included without opening the invoice. Quotes are listed the same way. The patient's name at the top of the form opens their record in the same way.
Everything about the money is done on the form itself. New quote opens the quote builder for the patient, and Back returns here once the quote is saved. New invoice makes an empty invoice on the case and opens its Change panel, where Add a procedure finds each procedure in the catalogue and prices it from the price list. Earlier quotes lists every quote the patient has that has expired, been declined or been superseded, saying which; Open takes it to the quote builder, where it can be revised into a new one. This patient's other invoices lists their invoices that are not on this case; the number opens one, and Link to this case puts it on the case. Each list shows the newest six, with Show the other for the rest. Both lists are open when the case has nothing in date to use, and folded away otherwise.
Where a case has no invoice yet, Use this quote makes one from the patient's quote. If the quote offers Enhanced or Ultimate packages, pick the one the patient chose first; Ultimate includes Enhanced, and nothing is picked for you. Only the chosen package is billed. Every line on the quote goes onto the invoice at the price quoted, and so does the quote's multiple-procedure discount; a line's variant goes on at the variant's current fee, which is the figure the invoice's own total uses; if any line does not keep its quoted price, the page says so and names the quote to check against.
Where the case already has an invoice and the patient has accepted another quote, such as a revision of the one it bills, Use this quote takes that quote onto the invoice in place of the old one. The invoice names the quote it bills now with its date and total; the first press shows the quote that replaces it and what the invoice will say and owe, and the second writes it. The invoice keeps its number and its payments, no second operation is made, and the change is on the case's log. Only an accepted quote not billed anywhere is offered, and it is not drawn on a cancelled or past operation.
Under the note are the photographs, the letters and the payment position, so the three questions asked standing at the case do not mean leaving it. Letters lists every letter about the patient, newest first, with who it went to, who signed it and whether it has been approved; pressing one opens it on the patient record, where its text is and where it is edited. Payment gives what this operation has been invoiced and what is still owed, with each invoice underneath; pressing one opens it. Where either could not be read it says so in those words rather than showing an empty list, because "nothing invoiced" and "I could not look" are different answers.
At the foot of the operation note is the time it was read, and Refresh reads it again. Anything you have typed is saved before it does, so refreshing cannot cost you a sentence.
Energy device is an Intraoperative data collection point like the others: its folded line says what was used, and opening it gives the device, with None as an answer. For a device that treats regions there is Regions treated, one box that shows what is ticked as chips and opens a list to tick from, and a line for the settings. Everything is written as you choose it. Where it is not on the note, type energy in the Intraoperative box, Add a data collection point, and choose Energy device; Remove beside it takes it off again. In Details, under the operation, knife to skin and procedure end sit on one row.
Choose Other where the device is not on the list and its name is asked for beside it. Add puts that name on your organisation's list, so everyone at the organisation can choose it from then on, and chooses it here. A name that is already on the list, however it is spelled, is chosen and not added a second time, and the line beside the box says which. A device added this way treats no regions and asks for no name until a Director changes that under Energy devices in Settings.
The sketches drawn on a tablet for the operation sit beside the note, as small pictures with when each arrived; pressing one opens it full size over the page, and Close, or Escape, comes back. The templates for the note, their pills and the controls to save or start again, sit under the note's box. Update it overwrites the chosen template with this note, its instructions and its data collection points; Save as new keeps them as a new template under the name typed beside it, which the template search then finds.
The operating surgeon signs the note from their own sign-in: type your PIN and press Sign. Signing locks the note, which is then read-only here and in Fedelsoft. Like every other data collection point, the energy device is not needed for the note to sign.
To change the procedure, whether it was booked wrongly or the patient has changed their mind, even on the day and even once the invoice is paid, press Change on the invoice under Procedures and costs. It lists what the invoice bills: tick Take off beside anything that should go, and find what it should bill under Add a procedure, which searches the catalogue by name or code; each result shows what it would cost on this invoice, split into procedure, anaesthetist and hospital fees, priced from the price list for the invoice's payee, so you can decide before you press Add, and Remove takes it back off the list before anything is written. Every line you do not tick stays exactly as it is, discounts included. Where the patient has a live surgical quote, you can choose to bill that quote instead, and the invoice's lines become the quote's at the prices quoted. Then give the reason and press Create invoice, or Change invoice where you changed lines: the first press shows the invoice as it will be, beside what it says now, and the second writes it. Changing anything in the panel in between puts the button back to its first press.
Where the case already has an invoice and the patient has an in-date quote, the quote is listed under the invoices with Bill on invoice and the invoice's number. It opens that invoice's Change with the quote already chosen and puts you in Reason. This is the way to bill a revised quote: the invoice keeps its number and what has been paid on it. New invoice on a case that already has one asks first, naming the invoice already there, because a second invoice leaves the first to be voided. An invoice made here is dated the day it is made.
Where nobody has typed the operation's name, it is read from the procedures on the case's invoices, and its estimated length from theirs. An invoice that has been voided, or is in the recycle bin, is left out of both, so once a revised quote is billed and the old invoice voided, the operation note, the booking form and the theatre list name the new procedures and time them from it.
Give the reason and press Preview: nothing is changed yet, and the page shows what the invoice says now, what it will say, the new total, what has been paid and what is left to collect, or the refund owed where more has been paid than the new total. Confirm makes the change. The invoice keeps its number and its payments, and its log, and the case's, keep what it said before, the reason, who changed it and when. A paid invoice that now bills more is marked part paid again, so the rest is chased. The duration and the nights are not changed with it: Times shows what the new procedures add up to, so set the duration there, and the nights under Requirements.
Where the post-operative instructions do not mention the first wound check, a card under the Instructions box says so when you leave the box and once more when you press Sign: Add wound check puts a line in for you to finish, and Leave as it is carries on. The card stays away when the Instructions mention it or when the first wound check instructions have been ticked on the note. A Director switches it on under Prompts on Surgery payments, for their own organisation.