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Logging Inback to top

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Logging in Using Active Directoryback to top

Please contact your local IT support to help you log in through Active Directory.

Please Note: If you are logged in to the PC itself as a network user and you go to the OpNote screen, you will be automatically logged in. See the next topic for when you are logged in to the PC as a generic 'User.'

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Logging in Using OpNote Log In Screenback to top

Please Note: If you are logged in to the PC itself as a network user and you go to the OpNote screen, you will be automatically logged in. You will not have to sign in using username, password, etc. The following instructions are for when you are logged in to the PC as a generic 'User.'

1. Select your home institution from the dropdown list.
2. Sign in with your personal username
3. Enter your password
4. Hit the "Log On" button (or press enter on keyboard)

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Navigating the OpNote Dashboardback to top

• Top Banner Links: found at the top of the page.
• Home: Takes you back to the Dashboard. From there, users can view the schedule, launch new reports and discharge summaries for procedures or review previously created reports that need attention (amendments/signatures).
• Admitted: Isolated list of all admitted patients available for reporting from any doctor. This list is automatically updated as OpNote receives messages from your hospital's system.
• Schedule: This link takes you to a separate screen where you can see any scheduled appointments that have been entered for you, the surgeon. Not every site has scheduling, and surgeons will just use the "Admitted Patients" list to launch reports.
• To Do: Isolated list of completed procedures that require reports. Once the date of the surgery arrives, the appointment is automatically moved from "Schedule" to "To Do." At this point, you (or your residents) are now able to create a report for that procedure. Not every site has scheduling, therefore not every site has "To Do" and surgeons will just use the "Admitted Patients" list to launch reports.
• Attention: Isolated list of reports that require attention from the user. This could mean completing and signing out on the report, reviewing and approving a report prepared by a resident, or signing an amendment.
• Signed Out: Isolated list of all your signed out operative reports. You are able to filter by date of completion, revisit and review the reports, or generate amendments on these signed out reports.
• Defaults: Manage, review, modify and create default reports for your most common procedures based on the CPAC templates. For more information on Defaults, please visit the "default section" of this help text.
• Next to your name on the right hand side there is an arrow indicating drop down. Click on that arrow to find:
• Log Out: End your OpNote session.
• Help: Instructions, tips and tricks, FAQ to enhance your OpNote experience.
• Support: Contact OpNote support through live chat or through emailing. Customer Support representatives will work closely with you to solve any issues you may be experiencing.




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Creating a New Reportback to top

• There are 2 ways to start a new report - you can either Launch a New Report from a Scheduled Appointment or you can Launch a New Report from an Admitted Patient.
1. Scheduled Appointment: Scheduled reports are entered by an assistant or pulled from the scheduling system. They will already be on your dashboard when you log in and will show up in the "To Do" column. To create a report for a scheduled appointment, click on "New Report" on the appointment card. After clicking the "New Report" button, you will have two choices for the type of new report:

• Default Report - Default reports are your most common responses to your most common procedures based on the CPAC templates. When beginning with OpNote, you will not have any defaults, but you can build them up as you use OpNote. This will expedite the reporting process and allow you to ensure your own preferences are automatically incorporated.
• Blank Template - Select this if you don't have a default for the procedure or if you don't want to use one in creating your report. The templates are based on the CPAC templates and correspond to specific organ sites (Breast, Colon, etc.).

If you used To Do column to create a new report, skip ahead to Edit Note. If you are using Admitted Patients, please read below.

2. Admitted Patient:: If your facility is not using a scheduling system (automated or manual), then you will launch your new reports from the 'Admitted Patients' column on the far left of your screen. Scroll through to find the patient on which you wish to report, then click "New OpNote." You will now have two choices for how to create this report:
• Default Report - Default reports are your most common responses to your most common procedures based on the CPAC templates. When beginning with OpNote, you will not have any defaults, but you can build them up as you use OpNote. This will expedite the reporting process and allow you to ensure your own preferences are automatically incorporated.
• Blank Template - Select this if you don't have a default for the procedure or if you don't want to use one in creating your report. The templates are based on the CPAC templates and correspond to specific organ sites (Breast, Colon, etc.).



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Editing the Operative Reportback to top



• The "Edit Note" page is divided into two distinct columns. By clicking on any section of the left hand column, you access the right hand column
• Right Hand side of the screen are all the possible choices for content in that section. This may include number pads, free text, or lists of multiple entries from which you can select one or more responses as the section necessitates.
• Left Hand side of the screen is the final content that will show up in your report after you have selected them. Entries clicked in the right column show up in the left column.
• After finding the selection in the right hand column that suits your needs, click it and it will be highlighted and added to the report (as seen on the left).



• You can remove answers by clicking on the selection in the right hand column a second time, it will be deselected and removed from your report. Or you can click on the big red X that appears next to your selection when you are in that section.



• After your operative report has been completed choose Sign Out link in the header at the top of the screen.



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Sign Out Pageback to top




• Sign Out is where you review the report in its entirety and, if needed, can go back to edit the page to make corrections (you can return to the previous page by clicking the "Edit" link at the top of the page).
• When you select the Sign Out button, you'll finalize the report and electronically sign it out. The report is now signed out with a date and time stamp and will be sent back into your facility's system.



• You can Download PDF to save the report as a PDF.
• If you want to save your completed report - either as a new default report or an updated version of a default that has already been saved - then select Save this report as a new default report and name it how you would like it to appear.



• Default reports should cover most common procedures to save you time and effort in future creation of operative reports.



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Making Amendmentsback to top

• If you need to make a change to any part of your report - or if you need to add any other information - OpNote's Amendments feature will help you.
1. Locate the report you want to amend in your Signed Out reports screen. Select View and you'll be taken to the signed out report.



2. The report is signed out. But if you want to add anything, click on Create an Amendment (on the right).
• OpNote takes a few seconds to copy over all of the previous responses before generating a copy of the report for you to amend. This is done in accordance with various standards and legal requirements.
3. Make your changes (adding, removing responses, etc.) and then sign out the amendment. You can see the listing of the signatures at the bottom, noting when the report and its subsequent amendments were signed.






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Supportback to top

• If you are having problems using OpNote, please do not hesitate to contact us. The support button is on every page of Opnote, found in the drop down next to your name in the upper left hand corner.



• Select it and then choose to either chat with mTuitive (via instant message) or email mTuitive with the problems you are encountering - complete with a screenshot.



• mTuitive has a long history of excellent customer support for all of its products and is committed to working with you until you are satisfied and comfortable using our products.

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Making Sure Your Browser is Up to Dateback to Tips & Tricksback to top

• OpNote works best in a modern web browser. Newer browsers are faster, more secure, and give us more features to make a great product for you.
• Download the latest version of the following:
• Google Chrome
• Mozilla Firefox
• Apple Safari
• Internet Explorer
• We are happy to walk you through installation. Contact us if you need any help.

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Creating Default Reportsback to Tips & Tricksback to top

• Default Reports are a great way to save time. By entering in the usual responses for your most common procedures in the templates, you can quickly review your report and sign out faster than dictation.
• It's important to note that default reports are not rigidly confined to the selections you chose when creating them; OpNote allows for users to make changes, entering in unique answers depending on the particular specifics of individual surgeries.
• The changes are easier to make in OpNote than dictation, as you can see how the final report will look instead of waiting for the transcription to see the revisions you made.
• There are two ways to create default reports:

1. Using a Pre-Existing Postoperative Reportback to Tips & Tricksback to top

• This is the most common way to generate a default report. After filling out all of the sections and fields in your operative report, you select Sign Out and on that page you will see the option to Save This Report as a New Default Report (the bottom purple box on that right hand side). Click on that option and enter in the title of your new default report (example - Lap Chole, Lap Chole w Veress, Lap Chole w Hassan, etc.).



• After saving, a confirmation will show up on the screen verifying the new default's name. Going forward, that report will be available as a default report that you can launch from your dashboard page.




2. Using Manage Defaultsback to Tips & Tricksback to top




• The Manage Defaults page is where you can access your default reports for the purposes of editing, deleting or creating new default reports.
• Manage Defaults can be accessed from your dashboard by selecting it on the top of your screen, labeled Defaults..
• On that page, you will see the option to Create New Default Note. Select that option, type in the name of your new default report and then go through the usual steps of selecting which CPAC template to use as a base.



• Make all of your selections, for your most common responses for that procedure in that template - filling out the default just as you would a live report. When you're done, click Home on the top banner and not Sign Out.



• In the future, should you need to make any changes to your defaults, you can go to Manage Defaults and make those changes, such as:
• Edit: Go in and change the most common responses in the various sections of your default report.
• Duplicate: Copy a default report over so that you can make one or two changes as an option. For example, you handle 1 procedure the exact same way except that half the time you use Incision X and the other time you use Incision Y, while everything else in the reports are the same.
• Rename: Re-label your default report so it's easier for you to recall what the report contains.
• Delete: If the default is no longer used, wanted or needed - you can delete it. Please Note: This action cannot be undone; once deleted, a default report cannot be brought back.

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I forgot my password, how can I retrieve it?back to FAQback to top

• If you are having difficulties with your password - or specifically with your Active Directory Password - please contact the NSHEALTH help desk at 1-902-470-7600.
• If you've forgotten your password to directly signing in to OpNote, click the "I Forgot My Password?" link on the front page and mTuitive will email you instructions on how to reset it.

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What if I chose the wrong patient?back to FAQback to top

• If you've chosen the wrong patient, then you will have to delete your report and start anew. You can delete the report by selecting the Home link on the top left of your screen. This will bring you back to the Dashboard. Find the report you just started under the Attention Required column and select delete.

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Can I add a new surgeon or assistant?back to FAQback to top

• Only System Administrators are allowed to create new Surgeons and/or Assistants. mTuitive coordinates with System Administrators on a regular basis to assure that appropriate staff are included in the OpNote system.

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Why was I timed out? What do I do next?back to FAQback to top

• Time out is one of the features of OpNote that was included for the security of surgeon and patient information. OpNote will automatically sign you out if the report is idle for a prolonged period of time. You can resume using OpNote by signing in again with your username and password, at which point you'll be redirected to wherever you left off when you were signed out.

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What do the green arrows mean?back to FAQback to top

• The green up and down arrows allow you to relocate the item either up or down in a list in a given section. They only appear in a select few sections. Click and drag each answer until you achieve the order you want to appear in your final report.

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Do I have to enter a response for each section?back to FAQback to top

• This depends on the CPAC template being used. Within each template are Required Fields that must be filled out when completing the reports. OpNote will not permit you to sign out the reports if any of these fields are left blank. In those instances, the following prompt will show up on the top of the page: And the incomplete field will show up in red text.

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If I don't sign the report out immediately, can I go back to Sign Out later?back to FAQback to top

• Yes. If you have started a report and need to finish at a later time choose Home located on the upper left side of the screen. Your report will be saved and can be opened on the OpNote Dashboard page. Once a report is signed out, it cannot be edited.

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Can I edit my report after I've signed it out?back to FAQback to top

• You can make changes or additions to signed out reports using the Amendments feature. A complete audit trail tracking what changes were made, by who and when is saved in the background by mTuitive. For more on the Amendment process, please go here.

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Manage Defaults - How do I edit and delete defaulted reports?back to FAQback to top

• If you would like to manage your defaults choose "Manage Defaults" in the banner section at the top of your dashboard page. On this page you can open a default report and make the necessary changes or completely delete the default report from your dashboard.



• For more information on how to use Manage Defaults please go to Using "Manage Defaults" section of help text.
• Please note: Editing or deleting a default report cannot be undone.

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Will this document be sent into my EMR/hospital's system?back to FAQback to top

• Yes, reports made in OpNote can be sent into your EMR/hospital's system. After signing out, your synoptic report will sent into McKesson HPF or Meditech (depending on which facility) and available there.

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What happens if my network connection goes down in the middle of creating a report?back to FAQback to top

• Luckily, none of the information you have entered before the network went down will be lost. OpNote constantly saves your progress - so that all of your information you entered in previous to losing the connection remains in the report and will available for you (under the "Attention Required" column) to complete when you re-establish a network connection.

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How do I find my report?back to FAQback to top

1. Signed Out Reports: If you are looking for a report that was signed out, go to "Signed Out" on the top of your dashboard. This brings you to all of the reports you've signed out. You can filter the view by Month/Year of appointment, adding appointments to the view by clicking "show more" on the bottom of the screen.
2. Unsigned Out Reports: If you are looking for a report that was started but not signed out yet, then select "Attention" button on the top of your dashboard. This brings you to all of the reports that require attention (either needs a signature on the original report or on the amendment). You can filter the view by Month/Year of appointment, adding appointments to the view by clicking "show more" on the bottom of the screen.

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How do I find my appointment?back to FAQback to top

• The next 10-15 appointments will appear on your dashboard under the Scheduled Procedures column. If you are looking beyond those, click on Schedule button on the top of your dashboard. This brings you to all of the appointments that are currently scheduled. You can filter the view by Month/Year of appointment, adding appointments to the view by clicking "show more" on the bottom of the screen.

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How does my appointment move from the "Scheduled" column to the "To Do" column?back to FAQback to top

• An appointment moves from Scheduled to To Do based purely on date and time. Once the time of the scheduled procedure has passed, it is automatically moved into the To Do column and ready for you to create a report. Please note: This requires either a scheduling feed or someone entering in scheduled appointments. If you are just using Admitted Patients to launch reports, then this does not apply to you.

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How do I delete an appointment?back to FAQback to top

• To delete or cancel an appointment before it occurs, simply click the red "Cancel" link on that appointment. A prompt will appear confirming your wish to cancel that appointment. By clicking OK, your appointment is now canceled. Please note: This requires either a scheduling feed or someone entering in scheduled appointments. If you are just using Admitted Patients to launch reports, then this does not apply to you.


• Please Note: If you receive your appointments from a scheduler feed or some other system integration, then that appointment will continue to appear every time the system updates until it is canceled within that system/scheduler/etc.

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How do I delete a report?back to FAQback to top

• Important Note: This Only Pertains to Reports that Have Not been Signed Out. You cannot delete a report once it has been signed out.
• If Appointment is in To Do Column: Simply click the red "Cancel" link on that appointment. A prompt will appear asking you to confirm that you want to delete this appointment/report from your dashboard. By clicking "OK," you are deleting that appointment/report and removing it.
• If Unsigned Report is in Attention Required Column: Click on red "Delete" link on that report (on the bottom). A prompt will appear asking you if you want to delete that report. By clicking OK, you are agreeing to delete the report and any work you may have done on it. That report will show up as a To-Do report column (hit refresh to make it appear there), then hit "Cancel" and it will be removed completely.

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Can I use images in my report?back to FAQback to top

• OpNote does have the capabilities of adding images to your report. However, each imaging system (and system of storing/cataloguing images in EHRs, etc.) is unique and depends on the type of scope used and image files created. If this is something that interests you, please contact us and we'll work with you on identifying your needs and the appropriate workflow to integrate images into your operative reports.

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Can I make changes to a signed out report for another surgeon?back to FAQback to top

• Administrators and Residents are able to make changes (via creating amendments) to reports signed out by a surgeon. However, only the surgeon that originally signed out the report is able to sign off on any changes made to the report. If the surgeon requests you to make changes for him/her, you can do that, but he/she will still have to review and sign out that report. After you make your changes, and select "Home" from the top banner, the augmented report will immediately show up in that surgeon's Attention Required column.

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What if my appointment gets canceled - but is still in to-do?back to FAQback to top

• Click the red "Cancel" link on that appointment. A prompt will appear asking you to confirm that you want to delete this appointment/report from your dashboard. By clicking OK, you are deleting that appointment/report and removing it.


• Please Note: If you receive your appointments from a scheduler feed or some other system integration, then that appointment will continue to appear every time the system updates until it is canceled within that system/scheduler/etc. Contact the person in charge of scheduling appointments to ensure it is canceled in that system as well.

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What if I chose the wrong default when creating my report? What if I chose the wrong template?back to FAQback to top

• If you accidentally selected the wrong default/template for a report, hit Home on the top of your screen. This will bring you back to your Dashboard.
• Locate the report with the incorrect default/template in the Attention Required column. Click on red "Delete" link on that report (on the bottom). A prompt will appear confirming that you want to delete that report. By clicking OK, you are agreeing to delete the report and any work you may have done on it.
• Hit refresh on your browser. The appointment will now show up in your To Do column (if using scheduling) OR the patient will still be in Admitted Patients. Click New Report on that appointment under To Do or New OpNote for that patient under Admitted Patient and select the correct default/template you wish to use.

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What are these templates I'm using? Can I make changes to the fields/sections?back to FAQback to top

• The synoptic reports you are filling out are based on templates created by committees of surgeons for the Canadian Partnership Against Cancer (CPAC). As they are updated, some of the sections might be revised, altered or even eliminated and more operative sites (and procedures) will be added as well. mTuitive will work in conjunction with CPAC, eHealth Nova Scotia and other organizations to make sure that you are well informed of any changes being made.
• Any changes to templates will be decided by these CPAC committees. If you wish to make changes to the content of the fields and sections of these templates, mTuitive suggests contacting your Synoptic Reporting Project Manager.

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I perform surgery at multiple hospitals. How will I get access to each hospital's information?back to FAQback to top

• If you are logged in to your Active Directory account on a computer, then OpNote will automatically know at which location you are currently performing surgery. However you are able to select a different location by going to the direct Log-In screen of OpNote and selecting for which site you wish to do reporting. All of the patient and staffing information for each facility is kept up to date and separate from the other facilities.

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I am a Surgical Resident - what's my role in OpNote?back to FAQback to top

• As a surgical resident, you are able to log in and initiate reports for your surgeons. You will create and complete reports - but they will still have to be signed out by your attending surgeon. Your attending will review the report you filled out, make any corrections needed and then sign it out.

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What is the "Report Copies to" field?back to FAQback to top

• At the top of the report, underneath the staff for that surgery, is a field labeled "Report copies to." In this section, users can select which other physicians (GP, pathologists, etc.) or staff members of the hospital they would like to receive copies of this report.

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Can I enter multiple assistants and/or anesthesiologists for my report?back to FAQback to top

• Yes, you can select as many assistants and anesthesiologists as you require from the list.

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What's a Discharge Summary? How do I start one?back to FAQback to top

• Discharge Summaries are additional reports whose content is mandated by CPAC committees. The Discharge Summaries are different depending on which template was used/which surgical site. In places where the fields/sections are repeating information from the surgical synoptic report, OpNote will bring that information automatically over. Once you've signed out your surgical synoptic report, you'll notice that a Discharge Report To Do is now ready to go for that patient. Click "New Report" to complete that Summary.

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Can I use OpNote for creating reports on non-CPAC template procedures?back to FAQback to top

• Outside of Nova Scotia, OpNote is currently used by many surgeons in multiple specialties for their reports. Eventually, OpNote may be expanded to included non-CPAC template procedures. If you are interested in using OpNote for other operative reporting, please contact your Synoptic Reporting Project Manager.

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I noticed that the report's fields and sections sometimes change depending on what I enter. Why is that?back to FAQback to top

• As users enter in responses into the report, you might notice that some fields either disappear or show up, and some others have other responses added to them. OpNote is built to include such automatic calculations, rules and other intelligence which will reduce the amount of redundant information users have to enter, or eliminate those fields that are not applicable.

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What do I do when I need to create reports for patients, but I don't see them in my Admitted Patients list?back to FAQback to top

• If you need to report on a patient, but don't see that patient in your Admitted Patients list, there's a good chance that the patient was admitted to a different physician. But you can still create and complete a report for that user. Under the Operative Reports To Do column, click on the button that says "New Operative Report."



• You will then select which default/template to use to fill out your report. Once you've made your selection, hit "Begin Report."



• You will then enter the MRN, account number or health card number to find the Patient on which you wish to report. Then you will fill out the report as per usual and sign out.

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I need to add Assistants or Anesthesiologists to the report, but their names aren't listed. What do I do?back to FAQback to top

• If there are personnel that aren't available for selection in your report, please contact your OpNote Administrator who will be able to quickly and easily add that person to be a selection for your reports.

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FOR ADMINS: I'm an Admin - what does my dashboard look like? How do I navigate it? back to FAQback to top

• Administrators will notice that their dashboards look different from the surgeons' dashboard. For one thing, they are able to see all patients, appointments, reports, etc. - not just isolated to one surgeon's view.



• Furthermore, a few of the fields are not included on the Home Screen but instead can be found by using the banner links on top.



• On each of those screens, Admins are able to change the view to only look at the Signed Out Reports of a particular surgeon, or the Admitted Patients for a particular surgeon, etc.

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FOR ADMINS: How do I manage Users? How do I add Users?back to FAQback to top

• By selecting the Users link in the top banner, Admins will go to the Users screen where they can create, modify, or suspend User accounts.



• On that page you can see which users are currently online, you can edit their profile, export their defaults to other users. You can also add new users with two different methods:



• Selecting Unregistered Providers brings Admins to a screen where you can see any providers (surgeons, assistants, etc.) that don't have an OpNote account. You can then convert them and make an account for those physicians.



• Selecting Create a new user brings Admins to a screen where you can fill out the users' profiles and set roles and capabilities. Those users will then receive an email and they will activate their account.

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FOR ADMINS: How do I associate Users with their Active Directory login?back to FAQback to top

• When setting up users, Admins may want to associate their OpNote accounts with their Active Directory accounts to make log-in easier. Admins can do this either at initial account creation or at any time afterward by going to Manage Users and selecting Edit on that particular user.
• On the User's profile page, on the left hand side, Admins will see a field titled "AD User name."

• Enter in the full Active Directory username and full domain-qualifed username for that user. For example, "smithj" isn't enough, but "cdha\smithj" is correct and will allow the accounts to be associated with each other.

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FOR ADMINS: Where do I go to review which Templates are being used?back to FAQback to top

• Select Templates to see which CPAC templates have been uploaded and what versions are being used.



• Click on the template title to see which version is being used, the history of the various versions. When a new CPAC template is released, or there is an update to a current one, mTuitive will upload it into OpNote.




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