Apps/The outpatient chart
OpOut-Pt
The outpatient chart. Pre-exam, a structured exam and the note, with growth, vaccines and preventive care where the specialty needs them.
Rolling outIn Outpatient Medical
Reason for visit. Blood pressure follow-up. Right knee pain for two weeks.
Reviewed
- MedicationsJ. Torres, MA · 9:44 amReviewed
- AllergiesJ. Torres, MA · 9:44 amReviewed
- ProblemsJ. Torres, MA · 9:45 amReviewed
Screeners
- PHQ-9Answered on screen3
- Tobacco and alcoholAsked todayDone
- Fall riskAsked todayDone
Preventive care and gaps to close
- Colorectal cancer screeningDue since MarchOpen
- Flu vaccineDue this seasonIn progress
- Blood pressure follow-upRecheck within 4 weeksOpen
- Tetanus boosterGiven 2023Closed
What it does
One visit, worked in turn by the people in the room.
The medical assistant and the provider work the same page, one after the other. What follows is built today; what is still being built is listed further down, and says so.
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Briefing
Before anybody walks in.
- What the last visit decided, diagnosis by diagnosis, and its plan
- Results back since, each a task for whoever ordered it until it is looked at
- Orders from earlier visits that are still out
- Calls and refill requests since the last visit, and what the patient did in Navia before coming
- Care that is due, and how the screeners have moved
- What the growth chart or psychiatry's monitoring is raising
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Pre-exam
The medical assistant's turn.
- Room and reason for visit
- Vitals, with BMI worked out
- Medications, allergies and problems reviewed, with who and when
- Screeners answered on screen, including PHQ-9 and GAD-7
- Tobacco, alcohol and fall-risk questions
- Preventive care and gaps to close, listed before the provider walks in
- Then "ready for the provider"
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Exam and note
The provider's turn.
- The story of each reason for the visit
- A symptom check by system
- A structured physical exam, normal by default
- The note assembled from all of it
- Assessment and plan per diagnosis
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Diagnose, order and code
What the visit was for, and what it is billed as.
- Today's diagnoses, the first being the main one
- Labs, imaging, referrals, vaccines and in-office procedures, each for a diagnosis
- A level of service suggested from the problems, the data and the risk, or from time
- The preventive code for the patient's age at a well visit
- Each vaccine's own code from the dose recorded, and modifiers the charges need, with why
- Checks before signing. The provider chooses the code
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Medications and close-out
Finishing the visit.
- Renew, change, stop and prescribe
- Prescriptions are printed or phoned in today
- A follow-up order
- An after-visit summary
- Sign, with a co-signer when one is needed
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The record
What stays on the chart between visits.
- Problems, medications and allergies
- Immunizations, with what is due
- Preventive care and gaps to close
On screen
An exam that starts out normal.
Every system begins as a normal finding. The provider changes only what is different, and the note is written from what the exam says.
Physical exam · normal by default
- General
Well appearing, no distress
Normal - Heart
Regular rate and rhythm
Normal - Lungs
Clear on both sides
Normal - Abdomen
Soft, not tender
Normal - Right knee
Mild swelling, tender along the inner joint line
Finding - Skin
Warm and dry
Normal - Neurologic
Alert, gait steady
Normal
The note, written from the exam
Exam. Well appearing, no distress. Heart regular. Lungs clear. Abdomen soft, not tender. Right knee with mild swelling, tender along the inner joint line. Skin warm and dry. Alert, gait steady.
Assessment and plan
Exam and note
Seven systems, one finding. The paragraph on the right is the exam, said in sentences. Sample data.
Before and after the exam
What happened last time, and what today comes to.
The Briefing gathers what the record already holds, from the places a provider would otherwise open one at a time. Diagnoses, orders and the code follow the exam.
Last visit · July 9 · H. Sorensen, MD
- I10
Above goal at 148/92 on lisinopril 10 mg. Increase to 20 mg.
Hypertension - E78.5
On atorvastatin 20 mg. Recheck lipids.
Lipids
The plan was: Lisinopril up to 20 mg daily. Metabolic panel in two weeks. Lipid panel before the next visit. Back in three months.
Results and orders
- Lipid panelBack Oct 2 · LDL 118, HDL 44Not seen yet
- Basic metabolic panelBack Jul 26 · potassium 4.4Seen
- EchocardiogramOrdered Jul 9 · 91 days outStill out
Since then
- Phone callSep 12 · dizzy on standing after the dose went up
Before coming in
- Getting ready in NaviaInsurance changed: new plan since SeptemberBegun
Care due
- Colorectal cancer screeningDue since MarchOverdue
- Flu vaccineDue this seasonDue
Screeners
- PHQ-9Today · was 4 in July3
The Briefing
The last visit and its plan, two results back, an order still out after three months, a call in between, what the patient did before coming, and what is due. Sample data.
Today's diagnoses · the first is the main one
- I10
Essential hypertension
Main - M25.561
Pain in right knee
2 - E78.5
Hyperlipidemia
3 - Z23
Encounter for immunization
4
Orders · each one is for a diagnosis
| Order | For | When |
|---|---|---|
| Basic metabolic panel | I10 | In 2 weeks |
| X-ray, right knee, 2 views | M25.561 | Today |
| Physical therapy | M25.561 | Now |
| Influenza vaccine | Z23 | Today |
| Lipid panel | E78.5 | Every 6 months |
Diagnose and order
Today's diagnoses, and under them the orders: labs, imaging, referrals, vaccines and in-office procedures, each one for a diagnosis.
Sample data.As the record shows
- ProblemsA chronic illness not at goal, and a new problemModerate
- DataA result reviewed, a test orderedLimited
- RiskA prescription medication changedModerate
Modifiers to add
- 25 on 99214Billed with vaccine administration the same dayAdd it
Charges from this visit's orders and vaccines
- 90471Immunization administration, first injectionAdd it
- 90686Influenza vaccine, from the dose recordedAdd it
Before signing
- Orders signedAll fiveFine
- A diagnosis on the visitFour, with a main oneFine
Coding
The level of service the visit as recorded supports, the preventive code for the patient's age at a well visit, modifiers the charges need, and what to look at before signing. The provider chooses the code.
Sample data.Specialties
The same visit, with what each kind of patient needs.
Specialties share one chart and differ where patients do. You choose the ones you practice; the price does not change.
Pediatrics Rolling out
Everything in primary care, with the tools a children's clinic needs and a look made for one: its own colors and rounder controls, on the same screens.
- Growth on the WHO and CDC charts, with the percentile for every measurement
- A fall or a climb across the chart's lines, raised on the chart
- Head circumference and age-appropriate vitals
- Milestone checklists by age
Weight for age
| Measured | Weight | Height |
|---|---|---|
| Oct 6, 2026 | 37.0 lb · 62nd | 40.7 in · 58th |
| Aug 14, 2025 | 32.2 lb · 60th | 37.8 in · 57th |
| Aug 20, 2024 | 27.3 lb · 59th | 34.3 in · 55th |
The well-child schedule
Every well visit from birth to 21 years, with what each one adds. Above it, what needs a look today.
- Done, due, missed and ahead, visit by visit
- Screenings each visit asks for
- Vaccines due and past due, with the first day a child who is behind can have each
Raised on this chart
- Weight has fallen from the 58th percentile to the 14thAcross two of the chart's lines since birthLook
- 2 vaccine doses are past dueDTaP and pneumococcal, third doses · both can be given todayLook
- The 9-month well visit is dueDevelopmental screening at this oneDue
The schedule
| Visit | Done | |
|---|---|---|
| 2 months | Feb 26 | Done |
| 4 months | Apr 29 | Done |
| 6 months | Jun 30 | Done |
| 9 months | Today | Due |
| 12 months | Ahead |
The immunization record
What is due now sits above what is on record. Each dose keeps its lot number, manufacturer and expiry, and the record prints for school.
- What is due now
- Lot number, manufacturer and expiry for each dose
- A printable record
Due now
- DTaP · dose 5Due between 4 and 6 yearsDue now
- Polio (IPV) · dose 4Due between 4 and 6 yearsDue now
On record
| Vaccine | Given | Lot |
|---|---|---|
| Influenza | Oct 14, 2025 | FL5-2291 |
| Hepatitis A · dose 2 | Feb 20, 2024 | HA-70413 |
| DTaP · dose 4 | Nov 16, 2023 | DT-55208 |
| MMR · dose 1 | Aug 22, 2023 | MR-31876 |
| Varicella · dose 1 | Aug 22, 2023 | VZ-90142 |
Psychiatry Rolling out
Medication management, with the monitoring that has to go with it. Starting a medication puts its checks on the chart, and doing one brings the next.
- Medication trials: dose, how long, how it went and why it stopped
- Adequate trials that did not work, counted by class
- Monitoring from the practice's own protocols, with what is overdue raised
- Consults asked of psychiatry, with how soon
| Medication | How it went | Adequate |
|---|---|---|
| Lithium 900 mg Mood stabilizer · added in July | Partial response | Not said yet |
| Escitalopram 20 mg SSRI | Stopped: side effects | Yes |
| Sertraline 200 mg SSRI · outside records | No response | Yes |
Adequate trials that did not work, by class
- SSRISertraline and escitalopram, each at a full dose for eight weeks or more2 of 2
Monitoring for lithium
- Lithium levelDue Aug 6 · never drawnOverdue
- Creatinine and eGFRJul 30 · creatinine 0.9 · next in JanuaryDone
- TSHJul 30 · 2.1 · next in JanuaryDone
| Client | Medication | Due |
|---|---|---|
| Young, Reid Last Aug 29 · left deltoid | Paliperidone 156 mg Every 28 days | 12 days late |
| Abara, Chidi Last Sep 10 · right gluteal | Aripiprazole 400 mg Every 28 days | Due today |
| Lindqvist, Tomas Last Sep 12 · left gluteal | Naltrexone 380 mg Every 28 days · gluteal only | Due Oct 10 |
| Bennett, Talia Last Sep 22 · left gluteal | Aripiprazole 400 mg Every 28 days | Oct 20 |
The injection clinic
Every long-acting injection, latest first, with the window, where the last one went and where the next goes. Each dose keeps its lot number.
Sample data.Mental status exam · normal by default
- Appearance
Well groomed
Normal - Behavior
Cooperative
Normal - Speech
Normal rate
Normal - Mood
"Tired, flat"
Finding - Affect
Constricted
Finding - Thought
Linear, goal directed
Normal - Insight
Good
Normal
Checks
- Prescription databaseH. Sorensen, MD · 2:02 pmChecked
- Monitoring labsH. Sorensen, MD · 2:03 pmChecked
Asked every visit
- Side effectsNone reported
- SleepAbout 6 hours
- AppetiteUnchanged
Risk
- Thoughts of suicideDenied
- Overall riskLow
Time
- Total30 min
- Psychotherapy18 min
Its own exam form
A mental status exam that is normal by default, what is asked every visit, risk, and time recorded with psychotherapy minutes.
Sample data.Still being built
What Out-Pt does not do yet.
We would rather tell you than have you find out.
Electronic prescribing
Prescriptions sent to the pharmacy from the visit. Until it opens they are printed or phoned in, and never marked sent.
In developmentResults sent by the lab
A result is entered against its order today. Results arriving from the lab on their own are not connected yet.
In development
Where it comes from
Out-Pt is the chart in Outpatient Medical.
- Rolling out
Outpatient Medical
One bundle for primary care, pediatrics and psychiatry, with the calendar and front desk, claims and payments, and messaging around the chart.
See the solution - Price
One price, any mix
$199 per prescriber a month. Every specialty you choose is included, and support staff are free.
The rest of the suite
Every app works from the same record.
One price
per prescriber.
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