Samantha 1.0 Users’ Guide

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Copyright

© 2017 NoteSwift, Inc. All Rights Reserved.

NoteSwift™ is a trademark of NoteSwift, Inc., in the United States or other countries. All other names and trademarks referenced herein are trademarks of NoteSwift, Inc. or their respective owners. Designations used by third-party manufacturers and sellers to distinguish their products may be claimed as trademarks by those third-parties. Dragon Naturally Speaking is a registered trademark or trademark of Nuance Communications.

Athena and other Athena marks are trademarks or registered trademarks of AthenaHealth, Inc. and/or its affiliates.

Images used under license from Shutterstock.com.

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Contents Copyright ................................................................................................................................................ 1

Thank You, and Let’s Get Started ............................................................................................................. 5

Notes About this Guide ........................................................................................................................... 5

Speech Recognition ................................................................................................................................. 5

Voice Commands ..................................................................................................................................... 5

Documenting with Samantha .................................................................................................................. 6

Basic Rules for Note Entry .................................................................................................................... 7

Common Questions ............................................................................................................................. 8

Entering patient words / current impression ........................................................................................ 8

Additional Rules by Section .................................................................................................................. 8

Allergies ........................................................................................................................................... 9

Social ............................................................................................................................................... 9

Review of Systems (or ROS) and Exam (or Physical Exam) ................................................................ 9

Plan ............................................................................................................................................... 10

Note Section Templates ........................................................................................................................ 12

Enabling and Selecting Note Templates ............................................................................................. 12

Dictating using Note Templates ......................................................................................................... 14

Navigating Between Sections ......................................................................................................... 14

Changing Templates ...................................................................................................................... 15

Starting from the Very Beginning ........................................................................................................... 16

Starting Up – No User Created Yet ..................................................................................................... 16

Options Menu (Gear Icon) ................................................................................................................. 17

Options Window ................................................................................................................................ 18

Setting up Samantha with Speech .................................................................................................. 19

Appointment View............................................................................................................................. 21

SOAP Note Entry ................................................................................................................................ 23

Current Patient Summary .................................................................................................................. 24

Correction Window ........................................................................................................................... 24

Medications....................................................................................................................................... 25

The NoteSwift Customer Experience Program ....................................................................................... 27

Troubleshooting ................................................................................................................................ 28

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Duplicate Items .............................................................................................................................. 28

Missing Cursor and Text Highlights When Dictating........................................................................ 29

Copyright ................................................................................................................................................ 1

Thank You, and Let’s Get Started ............................................................................................................. 4

Documenting with Samantha .................................................................................................................. 4

Basic Rules for Note Entry .................................................................................................................... 5

Common Questions ............................................................................................................................. 6

Entering patient words / current impression ........................................................................................ 6

Additional Rules by Section .................................................................................................................. 7

Allergies ........................................................................................................................................... 7

Social ............................................................................................................................................... 7

Review of Systems (or ROS) and Exam (or Physical Exam) ................................................................ 7

Plan ................................................................................................................................................. 8

Speech Recognition ............................................................................................................................... 10

Voice Commands ................................................................................................................................... 10

Note Section Templates ........................................................................................................................ 10

Enabling and Selecting Note Templates ............................................................................................. 10

Dictating using Note Templates ......................................................................................................... 12

Navigating Between Sections ......................................................................................................... 13

Changing Templates ...................................................................................................................... 14

Starting from the Very Beginning ........................................................................................................... 14

Starting Up – No User Created Yet ..................................................................................................... 14

Options Menu (Gear Icon) ................................................................................................................. 16

Options Window ................................................................................................................................ 17

Setting up Samantha with Speech .................................................................................................. 18

Appointment View............................................................................................................................. 20

SoapSOAP Note Entry ........................................................................................................................ 21

Current Patient Summary .................................................................................................................. 22

Correction Window ........................................................................................................................... 22

Medications....................................................................................................................................... 23

The NoteSwift Customer Experience Program ....................................................................................... 25

Troubleshooting ................................................................................................................................ 26

Duplicate Items .............................................................................................................................. 26

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Missing Cursor and Text Highlights When Dictating........................................................................ 27

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Thank You, and Let’s Get Started Thank you for purchasing Samantha from NoteSwift. We hope that you will find that she soon becomes

an invaluable part of your workday, helping to alleviate much of the burden of documenting the work

you do to care for your patients. At NoteSwift we are constantly working to make our products even

easier to use, adding updates that take on an increasing share of the burden of documentation in order

to free you up to provide higher and higher levels of patient care.

We hope that you will participate in our customer experience program where Samantha collects

anonymous information about your use of the product so that we can continue to focus on the areas of

the product that will provide the most benefit to you.

Learn more about the customer experience program here.

At any time if you have suggestions about how we can update Samantha so that she can take away more

of the documentation chore from you or if you run into any trouble using the product at all let us know

by sending an e-mail to support@noteswift.com.

Notes About this Guide - This guide is meant to help you with using and answering frequently asked questions for

Samantha software. The links in the guide can be used to navigate to different sections that will

answer the question or request that the link is a part of.

- There are portions of this document that include dictation help. Within the dictation, the

italicized words will input punctuation in the Samantha SOAPSOAP note window.

Speech Recognition You do not need to use speech recognition to document your notes using Samantha, but using speech

recognition often makes the process much faster and smoother. Samantha requires you to select a

speech recognition engine when installing the product and you will need to properly configure your

selected speech recognition engine in order to use speech with Samantha.

Note that if you are using Dragon Naturally Speaking the Dragon client must be installed on the same

machine as Samantha and Dragon must be started before you start Samantha.

How do I select and configure my speech recognition product?

Voice Commands After you login to Samantha your selected speech recognition engine is active and you can use your

voice, mouse, or keyboard while working with Samantha. The buttons on most screens can be “clicked”

by saying the name of the button into your microphone.

Note: If you are using Samantha’s built-in speech engine the “Previous” and “Next” buttons on the

Correction Window are not currently accessible using speech. This is expected to be addressed in a

future release.

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Documenting with Samantha Let’s assume that you’d like to have Samantha start documenting notes in the EHR for you as quickly as

possible. If you would instead like to learn about all of the advanced features of Samantha you can

follow the additional links included throughout this documentation. But if you’re looking to get started

quickly then follow these 2 steps:

1) Login to Samantha using the Samantha username and password you created previously

a. What if I haven’t created a Samantha user yet?

b. What if I don’t see a login page when I start the program?

c. What if I see an error about speech recognition when I try to login?

2) Double-click on a patient in your appointment list for the day

a. What if I don’t see any patients?

b. What if I want to use my voice to select a patient?

c. How do I find charts for patients who aren’t on my schedule today?

d. Can I see appointments for other providers I cover for?

If your screen now looks similar to the one shown here then you’re ready to create or update your note

for this patient:

What if I see a different screen?

Why do I sometimes see information in the patient summary and sometimes the summary is mostly

empty? Samantha pulls information from the current encounter or the most recent patient encounter

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document in the EHR. The amount of information displayed depends on how much or how little

information was entered in the EHR.

Note: In this document we will generally give instructions for how to dictate into the main Samantha

window. However, at any time you can either dictate into the Samantha window or you can type into

the window (or you can do a mixture of both).

Basic Rules for Note Entry Samantha will do her best to understand everything you say and to turn your dictated text into properly

coded and structured medical notes in the EHR. She does need a little help to do this, but if you follow

the 3 rules below then she will be able to enter the note information with the least additional help on

your part:

1) If you are using note section templates in Samantha, or a template from Dragon, you can

navigate below the appropriate section name and dicatate. If you will be dictating the names of

each section, start each section of the note by dictating the Section Name, followed by a new

line. E.g.:

a. “ROS newline”

2) Separate items within a section by dictating a comma between each item. E.g.:

a. “fever comma rash comma no swelling”

3) Enter additional notes/impressions for any item by putting the note text inside of quotes OR by

dictating the word “note” followed by a colon and then dictate a newline at the end of the note

text. E.g. to add a note in the middle of the items in the example from rule #2:

a. “fever comma rash quote the rash is sensitive to the touch and the patient says it has

grown in the past 24 hours end quote newline no swelling”

b. OR “fever comma rash note colon the rash is sensitive to the touch and the patient

says it has grown in the past 24 hours newline no swelling”

Samantha supports the following sections for note entry (you can say any of the variations listed in

quotes for each section):

• “HPI” (a.k.a. “History of Present Illness”)

• “ROS” (a.k.a. “Review of Systems”)

• “Allergies” (a.k.a. “Allergy”)

• “Past Medical” (a.k.a. “Past Medical History”, “PMH”, “Medical History”, or “Previous Medical

History”)

• “Social History” (a.k.a. “Social” or “SH”)

• “Medications” (a.k.a. “Current Medications” or “Meds”)

• “Exam” (a.k.a. “Physical Exam” or “Physical Examination”)

• “Assessment”

• “Plan”

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• (Or you can say “Assessment and Plan” as one section together)

Common Questions 1) Do I have to enter all sections in every note I dictate? No, Samantha allows you to dictate as

many or as few sections as you’d like at any time. You may, for example, decide that you want

to dictate the Exam and ROS details and then go back to dictate Assessment and Plan later.

2) Do I have to enter the sections in a particular order? No, the order of dictation doesn’t have an

effect on Samantha.

3) What happens if I dictate a section not listed here? Any sections not listed here will not be

processed by Samantha and once processing is complete you will see the text for any un-

processed sections will be left behind in the Soap SOAP Note Window.

4) Can I dictate the same section more than once in the same note? No, if you do that then

Samantha will only process the text from the first time you said that section’s name. In order to

add more items to a section you will need to go back to the already-dictated section and add

your additional notes and findings there.

5) Do I have to always dictate the headings for each of the sections? Is there a way to have those

entered automatically every time? Samantha with Speech offers the option to use Note Section

Templates so you don’t have to enter the sections each time. Click here to see details about that.

Also, Dragon has an option to setup commands that can input section headers into the note that

impressions can be dictated under.

Entering patient words / current impression As mentioned above, you can enter additional notes for almost any item you are adding to the note.

You do this by entering the note in quotes or by adding text starting with “note:” (“note colon”) after

the item. When using quotes be sure to put everything you want to enter as a note between “quote”

and “end quote”. Or if you want to use the note command then everything from “note:” to the end of

the line will be included in the note. If you are dictating then make sure to say newline before dictating

the next item or the next section you want to enter.

When entering problems into Past Medical History or Assessment and Plan if those items already have

notes in the EHR then any new notes you dictate will be appended to the existing notes.

In the HPI, ROS, Exam, and Assessment and Plan sections you can also enter an overall free text note for

the section. To do this enter the note either surrounded by quotes or starting with “note colon” before

entering any other items in the section.

Additional Rules by Section Some of the sections in the patient note support or require additional rules when dictating so that

Samantha can do the best job possible in coding and entering your notes in those sections of the EHR.

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Allergies To enter findings in the Allergies section of the note you can either simply start by saying the name of

the allergy or saying “allergy to” followed by the name of the allergy. To indicate the reactions caused

by the allergy you can say “causing” followed by a list of reactions, for example: “pollens causing hives

sneezing”. Separate reactions using spaces and separate allergies in the note by entering a comma or

newline in between each item.

Social In order to enter details for items you add in social history you can simply dictate the ‘item’ (e.g.

“tobacco use” or “seat belt use” or “caffeine use”) and then dictate the detail information after the

item you’ve dictated (e.g. “smokes 1 pack a day” or “always” or “tea”). For example: if you say

“tobacco assessment recently quit smoking” then Samantha will enter a Tobacco Assessment in the

EHR for the current encounter and will select “recently quit smoking” as a detail for the assessment.

Note: In this version of Samantha only one detail can be entered at a time for items in Social History.

Also, to get the best results you should start the social history entry by saying the name of the ‘item’ to

be entered and then follow it with the detail you want to enter, if any.

Review of Systems (or ROS) and Exam (or Physical Exam) In the ROS and Exam sections you can use the keywords “apply template” or “add template” followed

by the name of a template in that section of the EHR to apply a template of your choice to that section.

If a close match is found then the template will be applied automatically, but if there are several

possible matches or no good match then the Correction Window will allow you to select the specific

choice you want to use.

You can also bring in the ROS and/or Exam findings from the previous encounter by saying “apply

template” or “add template” followed by any of:

“from last visit”

“from last encounter”

“last visit”

“last encounter”

“previous visit”

“previous encounter”

“last office visit”

“previous office visit”

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In these sections you can also indicate that a specific item is not indicated by either saying “no” or “not”

before the item or saying “not noted” or “not indicated” after the item. For example “no wheezing” or

“wheezing not noted” will produce the same result in the EHR.

If you want to indicate that the examination was normal you can also say “all normal” and Samantha

will mark it as such in the EHR. After saying “all normal” you can also dictate items that are exceptions

to the fully normal exam.

Plan Under the plan section Samantha needs to know if the items being entered are Diagnoses, Orders, or

Prescriptions. Once you tell Samantha you’re entering one of those categories then you can separate

multiple items in the same category using commas or newlines as with items in the other sections.

The specific names Samantha will recognize for those labels are:

• “Diagnosis”

• “Order” (or “Orders” or “Ordering” or “Ordered Labs”)

• “Order Set” (or “Order Sets”)

• “Prescribe” (or “Prescribing” or “Prescribed”)

As with other labels in the note make sure to add a colon after the label so Samantha knows you’re

starting a new section.

Special note about Imaging/Radiology orders:

Samantha allows you to dictate a wide range of imaging orders by following the pattern:

‘scan type’ ‘body area’ ‘contrast instructions’

Or:

‘scan type’ scan of ‘body area’ ‘contrast instructions’

For example:

“MRI wrist and hand without then with contrast”

Or:

“CTA scan of chest and abdomen without then with IV contrast”

Or:

“X-ray of chest without contrast”

The currently supported scan types are:

• CT or Computed Tomography

• CTA

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• PET

• PET-CT

• MRI or Magnetic Resonance Imaging

• XRAY or X-RAY or XR

You can also easily associate a diagnosis with an order or prescription by using the keyword “for”. E.g.

you can say “Prescribing colon Prednisone 10 mg daily for Asthma” to automatically have Asthma

selected as the diagnosis when adding the Prednisone prescription. For prescriptions you can specify

multiple diagnoses per prescription using the word “and” to separate the diagnoses. For orders only

one diagnosis can be specified.You can also assign the same order for multiple diagnoses, if needed, by

simply dictating the order for each diagnoses needed.

When dictating prescriptions the more information you provide, the less you will need to fill in when the

Medications Window is displayed.

For example, if you say:

“Crestor”

Then you will end up needing to select the strength and fill in the dose count, dose type, number of

days, number of refills (if desired), dosing frequency, and associated diagnosis when the medications

window comes up.

However, if you say:

“Crestor 20 mg 1 tablet daily days 30 refills 3 for high cholesterol”

Then Samantha will automatically extract and fill in all of those details for you. Note that Samantha

recognizes common Rx abbreviations such as BID, TID, PO, etc. Note also that Samantha will

automatically calculate the quantity to order for you, but you can specify that by saying “Count <qty>”

or “Number <qty>” where <qty> is the number of doses you want to order.

When entering current or past medications you can also specify “unknown” for the strength, e.g. by

saying “crestor uknown daily”.

Note: For orders you must specify a diagnosis for each order or you will see an error in Samantha. Also,

the diagnosis you specify must be for a problem that is assessed in the current encounter. This is also

true for orders that are part of an order set.

Speech Recognition You do not need to use speech recognition to document your notes using Samantha, but using speech

recognition often makes the process much faster and smoother. Samantha requires you to select a

speech recognition engine when installing the product and you will need to properly configure your

selected speech recognition engine in order to use speech with Samantha.

Note that if you are using Dragon Naturally Speaking the Dragon client must be installed on the same

machine as Samantha and Dragon must be started before you start Samantha.

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How do I select and configure my speech recognition product?

Voice Commands After you login to Samantha your selected speech recognition engine is active and you can use your

voice, mouse, or keyboard while working with Samantha. The buttons on most screens can be “clicked”

by saying the name of the button into your microphone.

Note: If you are using Samantha’s built-in speech engine the “Previous” and “Next” buttons on the

Correction Window are not currently accessible using speech. This is expected to be addressed in a

future release.

Note Section Templates If you commonly dictate the same note sections for each patient encounter then you may find it

convenient to use Samantha’s Note Section Templates to automatically pre-fill the section headers and

guide you through the note entry process.

Note that these templates only work with Samantha Speech so that speech option must be selected for

the templates to be active.

Enabling and Selecting Note Templates In the Options window if you have Samantha Speech selected as your Speech engine you’ll see a tab

called “Note Sections” as shown below.

On this screen you will see:

Show Section Labels: Use this checkbox to turn section labels on or off when you are entering notes. If

this feature is turned off then “Use Template” and “Customize Sections” will also be disabled.

Use Template: This shows the current template that will be used and allows you to select another

option from any other templates that have been created.

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Modify Template: If you click this button you’ll see the screen below allowing you to modify the current

selected template.

New Template: If you click this button you’ll see the screen below that allows you to create your own

note section templates.

Delete Template: Clicking this button deletes the currently selected template.

On this screen you can drag any note sections from the left-hand side onto the panel on the right-hand

side. You can also drag sections up and down on the right-hand side to reorder sections as they will

appear in the note.

You’ll note that some of the sections have checkboxes indicating that there are optional sub-sections

that you can enable or disable in your template.

Template Name: Use this to enter a name for your template (or leave the default that appears there).

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Save: Clicking this will Save the template and select it as the active template for use when you enter

notes.

Cancel: If you click this then your changes will be discarded and no changes will be made to the selected

note template.

Dictating using Note Templates If you have a Note Section Template active then you will see something similar to the following when

you open a patient encounter in Samantha.

Here you can see that each section label has been entered automatically in the note and underneath or

beside each label there is a hint enclosed in brackets (e.g. [Allergies]). The text that appears in the

brackets when the note first opens is not included as part of the note, it is simply provided as a

convenient way to see the different sections.

As you enter text into each section it will replace the default text and all text you enter will be included

as part of the patient note when you click or say “Done”.

Navigating Between Sections As you dictate the note you have several options for navigating between sections. You can:

• Say “next”, “next field”, or “next section” to jump automatically to the next section in the note.

• Say “previous”, “previous field”, or “previous section” to jump automatically to the previous

section in the note.

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• Use the name of the section to navigate directly there. E.g. if you are dictating into HPI above,

you could say “Physical Exam” to go directly to that section of the note (skipping the 5 sections

in between).

• Use the mouse to click into the bracketed area in the section where you want to dictate.

Tip: Make sure you pause for a second or two after dictating items into the section before saying any of

the commands above to jump between sections so that the speech engine knows you are dictating a

command and not another item.

Each section has built-in voice hints for navigating between the sections. These are listed here:

• HPI – You can say “HPI” or “History of Present Illness”

• ROS – Say “ROS” or “Review of Systems”

• PMH – Say “PMH”, “History”, Past Medical History”, “Medical History”, “Previous Medical

History”, or “Past Medical”

• Allergies – Say “Allergy” or “Allergies”

• Social History – Say “Social History” or “Social”

• Meds – Say “Current Medications”, “Medications”, or “Meds”

• Exam – Say “Exam”, “Physical Exam”, or “Physical Examination”

• Assessment and Plan – Say “Assessment and Plan”, “Assessment”, or “Plan”

• Diagnoses – Say “Diagnosis” or Diagnoses”

• Orders – Say “Order”, “Orders”, “Ordering”, or “Ordered Labs”

• Order Sets – Say “Order Set” or “Order Sets”

• Prescribing – Say “Prescribe”, “Prescribing”, “Prescribed”, or “Prescriptions”

Changing Templates It is possible to change the note template after you’ve opened a note for entry. However, replacing the

template also replaces any text that was previously entered so take care to only switch templates before

entering text for the current encounter. A message will be displayed reminding you of this if you change

templates in this window.

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Starting from the Very Beginning If you’re looking for all of the details on setting up Samantha and understanding all of her advanced

features then this is the section for you. Here we will walk you through each of the screens you may see

in Samantha and talk about each of the settings in detail.

Starting Up – No User Created Yet If you’ve just installed Samantha on your machine then you likely do not have a Samantha User created

yet.After installing Samantha on your machine, Samantha requires you to create a user profile so that

you can specify the information Samantha needs to identify you in Athena.

When you start up Samantha, you will be prompted to create your first user. and no user has been

created you’ll see a screen that looks like this:

On this screen you will need to enter:

Display Name: This can be any name of your choice and will be displayed on the main Samantha screen

when you start the program in the future. If you create multiple Samantha users (e.g. to allow you to

easily switch between practices when documenting notes) then this will be the name you see on the

screen that allows you to change users.

Practice ID: This is your Athena Practice ID and is used by Samantha to identify the correct information

for your practice.

Provider: This drop-down allows you to select your name, or the main provider’s schedule you work

with, from the list as it would appear in Athena.

Email / Confirm Email: Please enter your email address here so that it can be used in the future if you

have trouble logging in.

Username: Select a username that will be easy for you to remember. This is the username you will use

when logging in to Samantha.

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Password / Confirm Password: Select the password you will use when logging in to Samantha. Note:

The username and password you use in Samantha are different from the ones you use when logging in to

Athena.

Once you’ve finished configuring the Samantha information for your new user click “OK” and Samantha

will connect to Athena and prompt you for login. The screen should look similar to the one below:

On this screen you see the current version of Samantha plus the Athena practice you are connected to.

When you first start Samantha it may take a moment or two before the Athena practice information is

displayed.

How do I view and update my Athena Practice settings?

At the bottom of this screen you will see the name of the currently selected Samantha User as well as a

link to click if you want to change the user. If you click the link you will see a window like this:

On this screen you can select a different user from the list provided, create a new user, modify the

settings and/or display name for an existing user, or delete a user.

Options Menu (Gear Icon) If you click on the Gear on the main Samantha window then she will show you a menu of options you

have. You can:

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• Select “Options…” to bring up the program options window

• Select “Check for Updates” to have the program go online to check for product updates

• Select “Help” to bring up the product Help (which happens to be this document you’re reading

now…)

• Select “eLearning” to bring up a browser with the Samantha eLearning Guides and videos

• Select “Dictation Help” to view commands and tips for using Samantha’s built-in speech engine

• Select “About” to view the product version, license information, and the End User License

Agreement

Options Window Clicking on Options… in the menu brings up a window that looks like this:

Clicking on the various tabs in the window will give you access to the following settings:

• Speech Engine

o Samantha Speech – If you’ve purchased the Samantha with Speech option then you can

select this option to use Samantha’s built in speech engine. See below for additional

details on the options available with this engine.

o Dragon Medical Practice Edition or Network Edition – Select this option if you use a

locally installed version of Dragon Naturally Speaking for your speech recognition.

o Other Speech Application – Select this option if you use a different medical speech

product including, but not limited to, M*Modal, Dragon Medical One, or SayIt.

o Input by Typing – Select this option if you do not want to use speech recognition and

want to type your notes into Samantha instead. (Note: This option is identical to

selecting “Other Speech Application” and is offered simply as a convenience. If you

select this option, click Save, and go back into the Options window you will see that

“Other Speech Application” will be selected automatically).

• Usage

o This screen allows you to control how much or how little information is sent to

NoteSwift as part of the NoteSwift Customer Experience Program. You can also turn this

feature on or off entirely on this screen.

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o Show me more details about the customer experience program and the settings on this

screen

• Corrections

o The slider on this screen allows you to adjust the sensitivity of Samantha’s correction

system. Here you can tell her that you’d like to see more items from the note show up

in the Correction Window or you can tell her that you’re confident in her accuracy and

you’d like to see fewer items come up for correction.

• CacheMisc

o As you work with Samantha she will remember some of your more frequent choices in

your notes and store those on the local system to improve performance overall. In rare

cases this local storage can interfere with recognition results which is why there’s an

option to clear the local storage (“Flush cache files”). This option should only be used

under direction from NoteSwift support.

o Select “Search My Shortlists” to be able to use shortlists from Allscripts in Samantha

while dictating

o Select “Clear Today’s Impression when updating existing diagnoses” to clear out existing

information in that encounter when updating existing diagnoses

• Note Sections

o This is the area to setup/edit your Note Section templates displayed in the SOAP note

window in Samantha

o

Setting up Samantha with Speech On the Options screen if you select Samantha with speech then you have 2 additional options you can

configure:

Microphone – Use the dropdown on the window to select the microphone you want to use for

dictation.

Microphone on/off hotkey – For some microphones it is convenient to setup a hotkey so that Samantha

will toggle the microphone on and off whenever that key is pressed. This is especially convenient for

microphones that do not have a supported push-to-talk feature. In order to change the hotkey for use

with Samantha simply place the cursor in the box next to “Microphone on/off hotkey” and then press

the key you want to set as the hotkey. To avoid conflicts when typing it is usually a good idea to hold

either Control or Shift while pressing the key you want to select.When setting up a hotkey, you must use

Ctrl+(the selected key).

Microphone Selection

The first time you select Samantha’s built-in speech option you’ll be asked to select the microphone you

want to use as shown in the following window:

Formatted: Normal, Indent: Left: 0.75", No bullets or

numbering

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User Setup

The first time you use the built-in speech recognition with a new Samantha user you will be prompted to

confirm or change basic settings for that user. The most important selection on this screen is the

Gender selection as recognition can be improved by matching the gender with the person who will be

dictating.

Microphone Calibration

The Microphone Calibration window will display automatically the first time you use a new microphone

if the built-in speech engine doesn’t already have information about that microphone. You can also

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bring up the calibration window anytime you’re using Samantha Speech by click on the microphone

button on the speech control window.

When calibrating the microphone simply follow the directions on the wizard. In case of a failure make

sure the microphone is properly connected, that you’re not in a very noisyyour environment is not too

noisy, and that you are speaking clearly into the microphone when instructed to do so.

Speech Controls

When you are using Samantha’s speech engine you’ll notice the following window on the screen:

This window allows you to see and control the current microphone state (listening or not listening

depending on whether or not the Record button is pushed down). The middle section of the window is

an audio meter showing the current level coming through the microphone and the button with the

picture of a microphone on it lets you launch the Microphone Calibration wizard for the currently

selected microphone.

Appointment View When you login to Samantha you will initially see your appointments for the day. You can also search

directly for specific patients and you can optionally view schedules for other providers, or even other

locations that are linked to your athenaClinicals account.

Note: The appointment view displays today’s appointments for the selected provider or providers. This

will be you by default when you first login. The appointments are pulled directly from Athena. If no

appointments are displayed then verify that there are appointments for the selected provider in the EHR

today.

The appointment screen will look like the following:

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You can click on “Search” to search for a specific patient, e.g. if you want to continue a chart for a

patient who had an appointment on a different day. Click “Other Schedules” to select other providers

and have their appointments show up here, e.g. if you are covering for someone else today. If changes

are made to the appointments in the EHR you can click “Refresh” to have those changes reflected in

Samantha. By default Samantha will show appointments for today. You can click “Date Range” to

change the dates used when checking for appointments.

Clicking “Search” will bring up this window:

Enter a partial or complete patient name to search for and hit Enter or click “Search”.

Click “Back” to return to the appointment screen.

Clicking “Other Schedules” on the appointment screen will bring up this window:

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Check the box next to one or more providers, as well as any other locations you’d like to view schedules

for, to have those schedules appear on the appointment screen after you click “OK”. Samantha will

remember your selections so that when you reopen the program and login you will see appointments

for the same selected list of providers/locations.

SoapSOAP Note Entry This window is where you will enter your notes either by dictation, by typing, or a combination of both.

See here for rules and suggestions on formatting your notes for best results. Once you’ve finished

entering your note click or say “Done” and Samantha will enter the details from your note into the EHR.

If there are any items that need your verification or correction then you will see the Correction Window,

described below. Once all non-medication items are entered into the note then you will see the

medications window, described below, if you dictated any past, current, or new medications in your

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note. After everything has been processed you will see a message window asking you if you want to

continue making edits or if you’re finished with this note. If you are finished then Samantha will take

you back to the appointment screen so that you can continue entering notes for other patients from

today.

Sometimes you may see text left behind in the Soap SOAP Note Entry window after Samantha has

finished entering the note in the EHR. There are several reasons why text may be left behind in the Soap

SOAP Note Entry window. In all cases the text that is left behind is the text that didn’t get entered into

the EHR and is left behind so that you can either change it so that Samantha can make the entry or enter

that information manually in the EHR. One reason why text would be left behind is if you cancelled from

the Correction Window or the Meds window. In those cases any text processed before you cancelled

will be removed from the SoapSOAP Note Entry window but all other text will remain. Other reasons for

leftover text include cases where Samantha received specific errors from the EHR when trying to make

the entries or where no matches could be found in a given section of the note.

Sometimes when I enter a note I see errors or warnings at the bottom of the SoapSOAP Note Entry

window. What do I do about those?

Current Patient Summary This window displays information about the current encounter for the selected patient. The amount of

information displayed in this window depends on the level of information currently available in the open

encounter for the patient. For example, if you are entering a note for a brand new patient with no prior

history in the EHR and no details entered at intake then you may see a summary that contains only the

labels for the different note sections. On the other hand, if the person who handled the intake for the

patient entered the Reason for Visit, Vitals, and Current Medications, and History then you will see that

information in the summary. Likewise, you will see information about the current Exam, ROS,

Assessment, and Plan if information has already been entered there for the current encounter.You will

see information about the patient from current and past encounters. Anything in BLACK is from the

current encounter. Items in GRAY italics, are historical items not in the current encounter.

When you enter a note in the SoapSOAP Note Entry window and click or say “Done” the summary

window will be updated with information from the new note as it is processed. You will see

“Processing…” in the sections where work is currently ongoing and you will see new text entries in either

Green, Orange, or Red color. Green entries indicate that the item was recognized accurately and a good

match was found in the EHR. Orange items indicate that there is some question about whether or not

the right match was found and that you’ll be asked to verify the item using the Correction Window,

described in more detail below. Red items are ones that caused an error of some kind. Errors caused by

entering duplicate items in the note can be easily corrected in the Correction Window. Other types of

errors may require additional steps to correct. How would I correct those errors?

Correction Window You will see the correction window while processing your notes if any of the items in the current note is

a duplicate with an item already in the note or is deemed to require verification. Items will continue to

Formatted: Font: Bold

Formatted: Font color: Background 1

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be added to the window as processing goes on and you can choose to correct items as they come in or

to wait for all items to be entered and then go through them all at once. You can also select “Cancel All”

at any time to cancel note entry and return to the Soap SOAP Note Entry window. If you cancel then no

changes will be made to the EHR and all of your original text will still be displayed in the SoapSOAP Note

Entry window.

For any item that is a duplicate you can either choose one of the alternate options from the list in the

middle of the window or you can choose to “Remove this Item” which will remove the entry entirely

from the note.

For items that need verification you can choose an alternate option from the list in the middle of the

window, remove the item, click “Next” to accept the item as-is, or click “Save Note” to accept this item

and all other pending items. You can also select “Prev” to go back to any items you’ve already

corrected. (Note that this will not allow you to go back to any items you have removed from the note

since these are also removed from the Correction Window when you choose that option). Notice that

any items that are corrected are changed from Orange to Green in the summary window and the

Correction Window also displays in Green for any items that have been corrected.

Medications Whenever your note includes any valid medications under “Current Medications” or “Prescribing”

under “Plan” you will see the Medications Window after Samantha has finished processing all other

non-medication items in the note.

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The screen above shows an example of the window you’ll see when there are medications in the note.

On the left hand side of the window you can see that there’s a section for Current/Past Meds and

another section for New Medications. If there are any new medications then the first of those will be

selected by default when the window opens. In the screen above all medications are ready to send (as

indicated by the green color used to highlight them). You can say or click “OK” to save all of the

medications or “Cancel” to return to the note in Samantha for further dictation and editing. If you don’t

want to save or send specific medications you can remove them from the note by clicking the button

with an ‘X’ on it next to the medication you want to remove.

If there is additional information Samantha needs you to enter before she can save the medications

then you’ll see something similar to what’s shown below where some of the medications are highlighted

in Orange and when you click on one of those medications one or more of the boxes in the window will

be highlighted in Red (indicating that the value in that box needs to be updated before the medication

can be saved). For example, in the screen below the dose count and quantity have not been set. If you

update the dose count with a valid number then the quantity will automatically be updated and the

selected medication will be ready to save.

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The NoteSwift Customer Experience Program Samantha is equipped with technology that allows her to anonymously take note of the areas you use in

the product as you use it. When you opt-in to the customer experience program Samantha sends this

information each day to the NoteSwift servers so that we can look at the areas most commonly used in

the product and make sure we’re focusing our efforts on the parts of the product that users benefit

from the most. This information also allows us to see where users may be running into trouble or may

not be able to take advantage of some of the product functionality which also helps us to improve

future versions of the product.

At install time you are asked if you want to participate in the customer experience program. If you say

“Yes” then Samantha will automatically collect and send the anonymous information as you use the

product. Note that we do not collect any personal information for you or your patients in this program.

You can also change your answer at any time as well as changing the amount of information that is sent.

This is the “Usage” tab in the Options Window in Samantha that allows you to change your selections for

the Customer Experience Program:

The options are as follows:

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• None – Select this to entirely disable any diagnostic or usage logging.

• Record error information only – This option can be used to limit the product logging to only

include information about errors that occur while you use the product. This can be helpful for

diagnosing problems, but since it includes only the minimum information it can require several

additional steps to troubleshoot issues when this option is selected.

• Log usage and error information … – This is the recommended option and is selected by default

if you opt-in to the Customer Experience Program at install time. When this option is selected

the product logs information about what areas of the product are being used (in addition to any

errors that might come up). No personal information is stored when this option is selected.

• Include information … allowing NoteSwift to troubleshoot product issues – This option may be

recommended when working with support to track down particular issues. If this option is

selected then the information tracked by the product includes the license key which allows us to

look up additional information helpful for troubleshooting.

• Include all available information – This is also called “verbose” mode. In this mode a lot of

additional information is stored in the logs which may help to track down particularly difficult

issues in the product.

• Automatically send log information to NoteSwift – This option is selected by default if you opt-

in to the Customer Experience Program. This option allows Samantha to send logs each day to

the NoteSwift servers which allows us to analyze aggregated data from all of the users who

participate in the program to determine what areas of the product are heavily used, lightly used,

and what areas might need additional focus.

• Send Diagnostics Now – Clicking this button causes Samantha to collect all of the diagnostic

information stored on your system into a ZIP file and to open an e-mail (if there is an e-mail

client installed on your system) with that ZIP file ready to send to support@noteswift.com.

Troubleshooting We certainly hope that you don’t need to visit this section very often. However, we know that there are

certain cases where you may run into errors with Samantha and this section may help to give you some

ideas in those cases.

Duplicate Items If you see duplicate item errors in the Correction Window when processing a note this indicates that the

item was already found in the patient’s record. For example, if you are dictated diagnoses and you

encounter a duplicate item error it typically indicates the problem already exists in the Patient Problem

list or Past Medical History for this patient or that it was already added and assessed in the current

encounter. Typically these items can be safely removed in the Correction Window since they are

already entered in the note elsewhere. Or, you can select a different option from the list of alternatives

that comes up if there’s another problem choice that better suits the patient’s condition.

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Missing Cursor and Text Highlights When Dictating If you are using Samantha’s built-in speech engine you may occasionally notice cases where you can’t

see the cursor or you notice that words do not appear to be highlighted when using the select command

(e.g. “select headache”). This is caused by other windows grabbing focus away from the window you’re

dictating into. Dictation will still work properly in this case, but if you want to see the proper cursor and

highlight behavior then you can click on the title bar of the window in question to restore focus to that

window.