1 | P a g e

Paragon Clinician Hub for Physicians (PCH) Reference

Logging in to the Clinician Hub

Paragon Clinician Hub (PCH) is available on any Carroll Hospital Network. VMWare View

must be utilized to open the application. Double Click on the VM View icon on your

desktop

Note: Please make sure the Domain is hospital.com and the Environment is LIVE. Now enter your USERNAME and PASSWORD

LIVE

2 | P a g e

Searching and Adding Patients to Your Census

1. If you have no desire to see anything other than patients you are the attending, admitting,

consulting or primary care provider for, leave your filters alone. You will see all of those patients

inpatients and outpatients.

2. However, if you wish to always see yours and your group’s patients, and only see patients that

you are rounding on, you must set up and save a ‘filter.’ First, click on Groups row in left hand

filter column. The groups you are part of will appear.

3 | P a g e

3. Check the individual group boxes, or the All box and ‘X’ out.

4. Next, click on Patient Type in the left hand column and choose the patient types you would like

to see on your list. All clinicians should choose Inpatient and Observation. Others may want to

add Emergency Room, Psychiatric, L&D Outpatient, Partial Hospitalization, or Series Wound

Care, Triage, or whichever patients you commonly round on.

4 | P a g e

5. To remove Pre-Registration and/or Recently Discharged patients from your census, click on

Status then uncheck Pre-Registration and/or Recently Discharged. Then, click on the “x” to the

right of the field.

6. After your patients display, click the Save (Filter) Button. Type in the blank field, ‘My Group’s

patients’ (or whatever you prefer) and click the save button to the right of the field.

7. Click the ‘Set as Default’ link.

You are finished setting up your filters!

5 | P a g e

You now have your Census! You can view your work list or select an individual patient.

t

Performing A Patient Search

1. The Patient Search field provides the ability to search for patients by name, medical record

number (MRN), or Visit ID.

2. To see all patients and patients that have been discharged, click “Options”, then uncheck

“Include Active Only”

As you start typing in the Name, MRN, or Visit ID, options will start to populate.

Note: A minimum of three characters must be entered for the name before the system begins a search. The patient search results list 15 patients that have the last names containing the characters entered. Last name matches are displayed first, followed by first name, and then middle name.

6 | P a g e

3. Click on the desired patient.

Patient List Information

A CodeStatus, if applicable. For example, DO NOT RESUSCITATE. (Placing the

mouse pointer over this field displays the entire code status description.)

An Isolation indicator, if ordered.

• Number of Alerts in the Workqueue for the patient

• Number of Tasks in the Workqueue for the patient

• Pregnancy indicator (if yes)

• Patient name(Last, First, MI) Note: If the Secure check box was selected for the

patient on the Visit Maintenance window in Registration, the text SECURED displays in red text to the MRN.

• DOB, Current Age, Gender

• Medical Record Number

• The text "Aliases" displays followed by the number of aliases for the patient

• Location(Nursing Station/ Room/ Bed or Outpatient location)

• DECEASED displays in red if the patient has been marked as deceased/expired in

Registration.

• The text "Patient Alerts" followed by the number of active patient alerts. Hover to

view.

• Admit date and time followed by the length of stay in parentheses Hover to view.

7 | P a g e

• Attending physician

• Race

• Primary Care Physician(PCP) name(if entered)

• Admitting diagnosis and any additional diagnoses

• Registering Facility

• Visit Status

• Patient Type

• Service

• Length of Stay(in days)

• Discharge date(if applicable)

Clicking the More Hyperlink opens the list in expand view.

Reports

Here you can choose an action:

8 | P a g e

Rounding Report:

This report is sorted by facility, nursing station, and room-bed. Patient/visit information includes the

patient’s age, sex, admit date, attending physician, primary care physician, and admitting complaint if

entered at the time of registration. The report also includes a calculated length of stay.

Face Sheet Report:

The face sheet generated from Clinician Hub is a pre-defined report that includes the following types of

data: Patient Information, Emergency Contact, Visit Detail, Caregivers, Guarantor Information (primary),

and Payor Information (for each pay or in order of primary, secondary, tertiary, etc.).

**Note: The patient must be highlighted before clicking the dropdown “Select An Action”

Selecting a Patient

Click on the Patients blue name. It will open the patient to the “Overview” screen.

Unlocking an Application: (Replacing the Black Lock in WSP)

1.) Have the patient in Focus

2.) Click the down arrow for your username and select Super User option.

3.) The Super Authority window opens and you can unlock the application

9 | P a g e

Patient Overview

The Overview window includes the following information about a patient:

• Vital sign data

• Intake and output data

• Active and recently ended inpatient medications and IV therapies

• Laboratory, Radiology and Ancillary results

• Active and recently ended orders

You can change the time frame while viewing from the Overview window.

Click the Overview Time Interval field

Select value; 4,8,12,24,48,or72hours

10 | P a g e

Documentation

With the patient in focus, click on the “DOCUMENTATION” tab.

11 | P a g e

Viewing Medical Records

Have patient in focus and click dropdown

Select Medical Records

MPF will launch

One Content now displays. If you wish to display a document or report on the right, click on it in

the left-hand column (document tree).

12 | P a g e

**To exit out of Medical Records, Click on another tab. Do Not click “CLOSE” on the top right if you want

to stay on that patient**

***If you want the document to take up your whole screen, click on the little up arrow to collapse the

side column***

Patient Sidebar

The patient sidebar provides access to the Patient Work queue and the Patient Profile data for the patient in focus.

13 | P a g e

Allergies:

To view allergies click on the “Patient Workqueue” and select “Allergies”.

Existing active allergies display in a collapsed view below the “Manage” button.

The system also displays whether the data is Unverified or Verified.

Clicking the “Manage” button will bring up the “Manage Allergies” window

Clicking the button will allow you to edit the Allergies.

If a yellow triangle will appear if the Allergy is non-coded.

14 | P a g e

To Add an Allergy

Click the Add button

The “New Allergy” window will open

Type in the first few characters of the allergy in the “Allergy” field. The allergies matching the characters entered display in the drop-down list.

If you want to enter any notes regarding the allergy, type them in the “Notes” field. Up to 150 characters can be entered

Inactivating an Allergy

In the Allergy window click the pencil icon next to the Allergy you want to inactivate.

Scroll to the bottom of the window and select Inactive in the Status field. The “Reason for Inactivating” window opens.

15 | P a g e

Type in the reason and click the Accept button.

Patient Demographics

To view the patients demographics, select ”Demographics” in the drop down.

16 | P a g e

Family History

Select family history in the dropdown.

You can view more information by

expanding on one of the names or hovering

over the name.

Click the “Manage” button to open the

Manage Family History window.

To add family history click the “Add”

button.

Immunizations

Select Immunizations in the dropdown.

Existing active immunizations display

below the “Manage” button

Click the “Manage” button to open the

Manage Immunizations window.

Medications and IVs

Select Medication and IVs in the

drop down.

All medication and IV orders are displayed for the patient. The data is view only.

The orders are grouped as follows: Stat, Routine, PRN, and IV Solutions

17 | P a g e

Non-Hospital Medication

Non-hospital medications include pre-arrival

medications and home medications

Select “Non-Hospital Medications” in the drop-

down list.

The “Home” icon displays next to Home Medications.

The text "(Pre-Arrival)" displays in green next to pre-arrival medications.

To see additional information about the medications, click the “Expand” down arrow.

To manage home meds, change the “All Meds” dropdown to “Home Meds” then “Manage”.

18 | P a g e

Click the pencil to edit or the “ADD” button to add a medication.

Clicking the “ADD” button will bring up the “Medication Search” window.

19 | P a g e

Viewing Non-Med Orders

Select “Non-Med Orders” in the dropdown

The orders are grouped as follows: Active (including Future orders), On Hold, and Recently Ended.

You can change the “Time Interval” by clicking on the drop down and selecting 4 Hours, 8, Hours, 12 Hours, 24 Hours, and 72 Hours

Viewing and Editing Problems and Procedures

Select Problems and Procedures in the

dropdown.

The default is “ALL” but you can change it to Active, Inactive, Chronic,

Intermittent, or Rule Out in the drop-down

Click the Manage button to open the

Manage Problems window

20 | P a g e

Note: By default, the Current List displays all entries regardless of their status. The Full List displays Active entries.

The Note icon displays if there are notes entered related to

the problem.

To add a problem click the “ADD” button. The “Problem Search”

window will open.

In the Search String field, type three or more characters for the problem. As you type, a drop-down list appears matching the characters entered

21 | P a g e

Once you select the desired entry, the “New Problem” window opens

To edit a problem, click on the pencil next to the problem and the “Edit Problem” window

opens.

Select the desired status (Active, Inactive, Chronic, Intermittent, Recurrent, Rule Out, Ruled Out, Resolved, Completed, or Entered in Error) in the Status drop-down list.

Flowsheets

You can access the flow sheets two ways:

1. Click on the patient’s name so they are in focus. On the overview tab you can click on the

in the top right corner of a pane to open the corresponding flowsheet.

2. Have the patient in focus and click on the flowsheet tab at the top

22 | P a g e

You can choose to view one or multiple visits at once.

Note: Icons to remember when viewing Flowsheets

Icons Description

Significant icon - Indicates a value that is considered significant for the patient.

Abnormal icon - Indicates a value that is considered out of range based on normal ranges

Multiple Folder (multi-views) icon - Indicates the presence of multiple entries for the time interval.

Progress Note icon - Indicates the presence of a progress note. Clicking on this icon opens the Progress Note pop-up window displaying the note.

Note icon - Indicates the presence of a note.

23 | P a g e

Intake and Output Flowsheet:

Information entered in Clinical CareStation is display in this flowsheet.

Medication Administration Record Flowsheet:

The standard MAR flowsheet groups medications as follows:

Routine, including all active medications on the patient's Pharmacy profile with the exception of PRN medications:

Unscheduled medications

Scheduled medications

Intravenous (IV)medications

IV piggy back (IVPB) medications

Chemotherapy medications

Respiratory medications

PRN, including all medications with a PRN frequency

Icon Description

Multiple folder icon - Indicates the presence of multiple entries for the time frame.

Medication not given

Medication is on hold

Medication had a scheduled dose

Medication is currently overdue

24 | P a g e

Nursing Documentation Flowsheet:

The following will display on the Nursing Documentation Flowsheet:

Vital Signs (including pain scores entered as vital signs)

Ventilator/Bed data

Measurements

Assessments (including pain scores entered as part of an assessment)

Progress Notes

25 | P a g e

Results Flowsheet

The Results Flowsheet includes lab, microbiology, diagnostic imaging (radiology), cardiology, and other.

You can view multiple visits at once by clicking the “Select Visit” drop down and select your visits.

More Flowsheets: You can customize what flowsheets appear

Click on “More Flowsheets” and then “Manage Flowsheets”

26 | P a g e

Once you find the flowsheet on the left, click and drag it to the right. You can have them in any order.

Click “CONFIRM” when you are finished selecting your Flowsheet.

**The Flowsheet with the lock icon cannot be removed. You can only change the order.

CPOE (Computerized Provider Order Entry

Have your patient in focus and select the “Ordering” tab

You will be able to search for orders by using either Order Sets or individual orders. Click on the

Search button.

For this example, I wanted to search the order sets for Potassium Aliquots. All order sets are

preceded by an asterisk (*).

27 | P a g e

In this example, I will select

Potassium Chloride IV Aliquots

Order Set. Once you have

entered the order, select your

desired dose.

Your order will appear on the

right hand screen. Then Click

Submit.

Lab Ordering

To order a lab, click on Search. In the search field enter the desired lab. Once you have found

your lab, click on it.

28 | P a g e

Complete the areas with a red asterisk (*)

When all required fields are completed, click on Submit.

To save all of your orders, click on Save. Please LIMIT saving orders and order sets. It is ALWAYS

preferable to submit your orders at the time of entry to reduce the likely hood of forgetting to

sign the orders. Submitting orders is equal to signing orders.

Radiology Orders:

Enter your Radiology order into the search field. With Radiology ordering, you will have an

additional required field which is the reason for performing the test.

Medication Orders:

Medication will be entered in the same fashion. You will have opportunity for practice during

your computer training

29 | P a g e

Order Sign-Off:

You can sign off orders two ways:

1. Once the patient is in focus, you select the “Bulk Order Sign” option in the “MORE” drop-down.

2. In “My Workqueue” you can

click on “BULK SIGN OFF”

Once selected, the patient’s

orders window will appear.

Select the orders you would like to sign off then click the “Sign-Off” button.

30 | P a g e

Work queue

In clinician Hub there are two work queues: “My Workqueue” and “Patient

Workqueue”.

Patient Workqueue shows to the left of the screen when the patient is in focus.

My Workqueue shows to the right of the screen and includes tasks for all your patients. It can

be viewed at any time.

Icon Description

CriticalAlert – Selected and Not selected

Abnormal Result

Regular Alert - Not selected

Regular Alert - Selected

Task- Not selected

Task- Selected

31 | P a g e

My Workqueue: You can filter your workqueue by clicking on the “View” or “Sort By” dropdown.

Note: Critical Alerts display at the top of the list and are highlighted in red.

The ordering physician and all members of the care team for the patient

receive Abnormal and Critical Result alerts. The system removes an

Abnormal or Critical alert from the Patient Workqueue and My Workqueue

for all who received it and replaces it with a New Result alert if the results

are corrected to be normal. In addition, if New Result alert is later

corrected to Abnormal or Critical, the Patient Workqueue and My

Workqueue are updated accordingly.

Tasks that can be found in your Workqueue are the following:

Complete Document

Co-Sign in CPOE

Co-Sign PhysDoc

Medication Reconciliation

Medication Order Renewal

Sign Off for Orders

Sign-Off Reject (Wrong Physician)

Unsubmitted Order

Click on any item in your workqueue

to view.

32 | P a g e

Click on the drop down to select an action

Select “VIEW RESULT REPORT” or “PUT PATIENT IN FOCUS”

ONLY CHOOSE “ACCESS CPOE”, “ACCESS FLOWSHEET”, and “ACKNOWLEDGE” if you are

planning to take action. It will remove that task from yours and your group’s workqueue.

Medication Reconciliation

To begin, click on the green Admission Medication Reconciliation START tab

Home meds vs Inpatient meds will display to prevent duplication

33 | P a g e

You will be required to Continue, Defer, Hold, Modify, or Discontinue medications. Be mindful

that the Green home icon identifies the home medication.

With Paragon, click on the Add order button to automatically order the reconciled medications.

You must do this prior to clicking on the complete button.

You may experience messages such as seen below. It is important to almost ALWAYS replace a

home med with a formulary item. Only in rare cases are patients allowed to take their own

home meds.

34 | P a g e

You will know the Med Rec is complete by the checkered flag. This is McKesson’s nod to NASCAR

since Paragon is based out of Charlotte, NC.

35 | P a g e

Deferring a Home Medication on Admission Med Rec

On Admission Med Rec, chose to

Defer this Home Med - Nexium.

Shows us like any other Home Med

would on both the Transfer Med

Recs and D/C Med Recs. No

indication it was deferred unless you

go back to the Admission Med Rec

Report and open it.

36 | P a g e