Trakcare FAQ

TrakCare
and ESR

For Doctors Induction
Support

PAGE 2

Table of Contents

Smartcard / Login 2
Vetting on TrakCare for Clinicians 3
To view a referral letter for vetting 3
To view the referral 4
To vet the referral 4
Recording Outcomes in clinics 7
Viewing Referral Letters in EPR 9
EPR Alerts and Allergies 10
Viewing ICE reports in TrakCare 12
Inpatients/Ward Access 13
Inpatients Discharge Letter 15
ECDS Clinical Summary in A&E 19
TrakCare Theatres Surgeon Access 20
Adding information through ACN 21
Medicines / Drug Charts 22
IT Training SharePoint Page access 32
Electronic Staff Record (ESR) 33

Smartcard / Login

Forgotten Smartcards

 User cannot use TrakCare without a CIS card registered to the
Trust

 User can contact HR to arrange for a temporary (TAC) card to
be provided for that day.

 User can also contact IT to arrange for a temporary login if a
physical smartcard is not required for the application

Lost Smartcards

 Please contact the HR department ext. 24023

5001 Errors

 Contact IT Helpdesk on ext. 22320

Single Sign-On – Logging into TrakCare

Log into TrakCare with your 4 digit pin number and select

Select the correct Spine role for your security – “see table right ”

PAGE 3

Spine Role Security Group
Clinical Practitioner Access Role ENXX Doctors EAU
ENXX Doctors Emergency
ENXX Doctors Inpatient

ENXX Doctors OP Consultant

Outpatients clinics

Vetting on TrakCare for Clinicians

Your vetting list will include
both manual and ERS (choose
and book) referrals. Manuals
list as ‘Initial’ as they have no
appointment booked, and ERS
list as ‘Appointment Made’ as
they have a provisional ap-
pointment booked.

Preferences
Status: Select ‘Initial’ and
‘Appointment Made’
Specialty: Select all the specialties your clinics are associated to
Referral Priority: Select ‘Routine’ and ‘Urgent’ (if you see 2 week rule patients,
these are dealt with outside of TrakCare – do not vet 2 week rules on
TrakCare).
Priority: Select ‘Not Vetted’ as this pertains to vetting
Hospital: Select all sites you hold clinics

To view a referral letter for vetting

To open up a patient’s referral to review: Put a tick against the patient, and
then click on the Specialty hyperlink.

PAGE 4

Outpatients Clinics Cont.

To view the referral

Click on the ‘Add / View Documents’ link (see highlighted
green box below)
This will open a pop up box called ‘Scanned EPR Docu-
ments’. Click on the path number to open the letter.

To vet the referral

You must look to see the Appointment Type that has been assigned to the
patient – this is vital to vetting. (You may see some appointment types with the prefix ‘Z
ERS…’ these are simply choose and books version of the Appointment Types and should
be used to make the vetting decision in the same way).
If you agree the patient is assigned to the correct appointment type, you should
select that appointment type from the vetting outcome list (see below).

PAGE 5

Outpatients Clinics Cont.

If there are any notes for the If there are any notes
patient arriving on the day of for the Booking Office
the clinic, they go here. to action, they go here.

If you disagree you should leave in the original appointment type then
choose re-direct and advise the correct appointment type in the
‘Booking Notes’ section. OR

If the patient should be sent back to the GP and doesn’t need an
outpatient appointment and you want to bounce the referral back to
the GP, you must select ‘Reject – back to GP’.

Setting Preferences to view clinics

 Select the blue preference hyperlink at the top of the screen A
 Select your preference e:g “Today’s care providers and their

sessions for this week” B
 Additional clinics > enter your speciality and choose the

consultant clinic you require. You can add others by typing the
Specialty again. C
 Click Update to save changes (See image on next page)

PAGE 6

Outpatients Clinics Cont.
A

B

C

 Once you have added all your clinics and clicked update you can
now set one as a default clinic to show every time you login. To
do this Select the blue preference hyperlink at the top of the
screen A and click
on eye glass for
default Display CP
box C and choose
your default clinic.
Then click update.

D

PAGE 7

Outpatients Clinics Cont.

Recording Outcomes in clinics

Find the patient on the clinic appointment list that has
been seen and click on the outcome icon for that patient:

The following screen will then be displayed:

For each of the 4 small boxes you would can record any activity you
completed with the patient. Note: the big boxes above the little boxes
do not do anything and you will need to add one item to small box and
then use Add to list button to save choices before you can add further
items to small boxes

1. Pathway Outcome box— in here you could record “Patient

1 Received Treatment” or “Outpatient
Procedure Done Today” or “DNA

No Further Appointment” or one of

the other Items in drop down list.

PAGE 8

Outpatients Clinics Cont.

2. Outcome box - You may use this box to record “Diagnostic Results
Received” or “Investigation Pathology Test” or
“Investigation X-ray/Ultrasound/MRI/CT”. This is

2 to record that you have reviewed result from
these test, not that you have requested the test.
There are other items in the drop down list that
you may use depending on your clinic type and
specialty.

3. Seen By box - You will need to type in the box the first few letters of

your surname and then a drop down box will

show names similar. You then need to find

your name or the consultants name who's 3

clinic you are supporting and select it.

4. Procedures box - This is the most
important box. Here you
would choose what
procedures you have

4 completed during your clinic
with the patient. You can
start typing the name of the procedure to aid in find-
ing it quickly. i.e. if looking for blood test type blood,
if looking for X-Ray start typing X-.

Once you have A
populated all of the 4 B
boxes you require, you
will then need to click
the “Add to List”
button. (A)

PAGE 9

Electronic Patient Record (EPR)

This will add all your selections in to the section at the bottom of the
page (B). This will also free up all of the boxes apart from the
“Pathway Outcomes box”, so you can add any other activates on to
patients outcome record.
Once you have added all you activates you can then press Update
button on page to save. Note: Don’t worry if you miss something you
can still go back to page to edit or add more items.

Viewing Referral Letters in EPR

You can open EPR page two different ways while in clinics view. You
can use the blue icon next to outcomes Icon linked to the patient or
preferably you can use the EPR menu in the main Menu bar. (See
above)
EPR Stands for Electronic Patient Record - In this page you will find
links to Alerts, Allergies, Documents, Observations, PACS link,
Maternity records and Operation Theatre Records.
You will find similar items as above now also in Active clinical Notes on
some wards like A&E and eventually all words in the future.

PAGE 10

Electronic Patient Record (EPR) cont.

A

B

When you go in to the EPR from the main menu, a popup page will
open and look like above. You will need to select the “Documents - All
Episodes” tab on left menu, this will give you some new menu options
at the top of the open window.

You need to click on “Scanned EPR Documents” (A) menu. You will
then see any GP Referral Letter saved there with the date that it was
sent.
Click on the “Path Number” to open document.

In the EPR window page you will also be able to access your selected
patients PACS reports and images by clicking the “PACs Link” (B)
menu on the side bar.

EPR Alerts and Allergies

C You can add Alerts and Allergies from the
menu bar in EPR by clicking the “New” (C)
the alert options only .. option at the top of main page.

This will open a window which will allow you
to add an alert to your patient. Some alerts
will add additional icons on you patient as
well as the alert icon .

Note: Penicillin and Latex allergies are not in
Allergies menu options, you will find them in

PAGE 11

Electronic Patient Record (EPR) cont.

If you click on the
eye glass (D) next to

D the Alert box you will

see a drop down list
appear with all alerts
you can add to a
patient. You can
start to type the
name of alert you
need to finds it
quicker.

When you click update after choosing alert you will be taken back to
EPR page and you will see all alerts you have added. (See below)

E F

To remove an alert from the
patient you will need to click on
to the edit blue circle icon (E)
next to it. This will open the
alert page to allow you to
change status. You will need to
tick the “Closed Flag box” (F)
to deactivate an alert.
Then click update.

PAGE 12

ICE Contextual Link in TrakCare

Viewing ICE reports in TrakCare

For your convenience, ICE can now be accessed from TrakCare. The
ICE icon will be displayed in the patient banner. Initially, you will
be able to view requests / results and file, a further development
will enable ordering.

Click on the icon and a new window launches displaying all orders for
the patient.

A

Additional options can be accessed using (A) the Services drop down-
list:

Attention: A small window also opens when

A the ICE icon is selected. This stops the user
from changing the patient in TrakCare with the

ICE window still

open. You will

need to click OK to

proceed.

PAGE 13

Inpatients/Ward Access

B

C

You are able to jump between security group within TrakCare. You

may be in a clinics and then be asked to add medicines to a patient on

a ward. You would click on the location blue text (B) at top right of the

main page and you security group window will show (C). You then

need to select the Inpatients Doctor Group to view ward information.

While working in

D the inpatient
wards you my

need to set your

E TrakCare Ward
Preferences to

allow access to all the wards you are working with.

Go to the end of white menu and press toggle icon. F
You will now see additional
menu lines. Find and select the
“Ward” menu (D). You will taken
to the “Ward Summary List”
page. On the left you will see a
blue preference button (E).
Select this to then see a popup
screen with all departments and
wards. To select multiple wards
you are working on you must
hold the Ctrl button on your
keyboard at the same time as selecting wards (F).

PAGE 14

Inpatients/Ward Access Cont.

To view patients on the ward.

You will need to select the

icon for “Patient List” (A)

view for your specific ward on

the Ward summary list.

You will then be able to see a

list of patients (B) who are

admitted to the ward and also

A visible will be information of
hand over note added by all

staff. (C)

B
C

The main front page you will see on a doctor Inpatient access will show
you a Care Provider Admissions summary list. (below)

D

You will need to set preferences (D) on this to only show patients from
you wards.
This list is a ideal quick list of patients whom you can select and jump
to EPR page or to discharge letter.

PAGE 15

Inpatients Discharge Letter

There are two ways to start and edit an inpatient discharge letter….
A

B

The quickest way is to select your patients and then select Clinical
Summary menu from the main menu (A). Then from the sub menu
select “New IDS” (B).
The second way of starting Discharge letter is by selecting patient and
then selecting “EPR” from the main menu. In the EPR page, select
“Documents all Episodes” (C) and in the main window under

Clinical Summaries tab select
“New” (D).

C D A new popup page will open,
(See below), You will need to click the
eye glass and choose from drop down
list “Inpatient Discharge Summary”

In both above
process you will
then be taken to the
first page of the
patients Discharge
Summary letter.

PAGE 16

Inpatients Discharge Letter Cont.

A

B
C
D

Fields to complete:
(A) Main conditions treated through the episode (Initial Diagnosis
Other conditions treated (Final Diagnosis)
Operation/Procedures
Investigation
(B) Prescriber / Bleep No. - Prescribing doctor, ensure your name
and a bleep number is entered in the Prescriber/bleep No. box in
order for pharmacy to be able to dispense

PAGE 17

Inpatients Discharge Letter Cont.

(C) Review Status – Pharmacy Under Review (unless Pharmacy is
being bypassed). Enter this once the medication has been
entered or if you make any subsequent changes to medication
(D) Important: - Enter a Status of ‘In Progress’ - The ‘Status’
should remain as ‘In Progress’ until such a time when the patient
is actually been discharged, as on authorisation the discharge
summary will be sent electronically to the GP
Clinically Complete – Once all details are complete place a tick in
this box upon completion of the discharge summary. Do not do
this until after a pharmacist has screened the prescription, unless
bypassing Pharmacy

AB

(A) Click the Co-Morbidity Details tab on the left side of the screen
Select whether the patient has Co-Morbidities by selecting ‘yes’ or ‘no’
(B) If ‘yes’, select the relevant Co-Morbidity and Conditions the patient
may have. Once you have entered your patients co-morbidities you
need to update status at bottom of page by choosing ‘Entered’ from
dropdown list. Click ‘Apply’ to save changes

PAGE 18

Inpatients Discharge Letter Cont.

Select Clinical Summary Detail tab.
Clinic Episode Summary and Follow Up Details are mandatory fields
e:g Complete all other relevant information regarding the patients dis-
charge.

AKI Details Section

If No there is no further action
If Yes complete all mandatory and any other mandatory fields

Palliative Care Details Section

Complete all mandatory fields and any other relevant information.
Section Complete by - this will auto populate with your name from you
smartcard login, as the care provider completing this section of the dis-
charge summary.
Apply Button will save any information already inserted. Update Button
will save the page.
Note: To edit the clinical summary details section, overtype or
delete the information already inserted and remember to Update.

PAGE 19

ECDS Clinical Summary in A&E

Highlight patient from the floor plan and select Active Clinical Notes
from the menu bar, Click the ALL tab in the
centre of the screen to view all the information
recorded against the patient prior to discharge
Click on the Entry Type spy glass and select
Clinical Assessment (ED) then click New.

Select ED
Diagnosis on
the left of the
screen to add
the patient’s
diagnosis
Input the
Diagnosis and
Qualifier ensuring the primary diagnosis is ticked as highlighted then
click Add then Update.
Next, Select Add Order on the left of the screen to add at least one of
the patient’s investigations, procedures and internal referrals using the
category and item fields as highlighted, adding processing notes if
required to pull across to the discharge summary.

Check all orders on the right of the screen and click Update.

On the summary page
check the orders and click
Update
Create the Discharge Summary by clicking the Clinical Summary Icon
and Work through ALL section on the left of the screen including the
ED Discharge section adding the discharge destination.
When complete set the status to Authorise and click Update.

PAGE 20

TrakCare Theatres Surgeon Access

PAGE 21

Adding information through ACN

Using Active Clinical Notes
Select the relevant patient from the Floorplan.
Check the correct patient has been selected from demographic
details on screen.
Select Active Clinical Note from the menu bar.
To add a new assessment records Click i.e. AE Clinician
Assessment from the Entry Type, then New.
Actions within the entry type will be displayed in the Action
section (left hand side) as illustrated below. Select an action and
complete i.e. Initial Assessment. Any notes added already will
be visible in main window.

PAGE 22

Medicines / Drug Charts

Within the Ward List or Floorplan, select the patient and select the
Active Clinical Notes menu item.

The Active Clinical Notes pane displays:-

Select the Medication Summary icon .
The Medication chart displays.

Medication Administration Chart: Default tab that is opened
when the user selects the Medication chart icon. The medications
displayed are grouped by route of administration. Medication can be
administered from this chart.
Current Medication: A view of all current medications pre-
scribed during the current admission in a list view. Includes On-hold
medication.
Completed and Discontinued Orders: A view of all medications
completed or discontinued during the current admission.

PAGE 23

Medicines / Drug Charts Cont.

Discharge Meds (current episode): A view of all discharge
medications prescribed during the current admission in a list view.
Meds 7 Day View: 7-day view of the medication chart. The default
date range displayed is three days either side of the current date.
Meds Profile: Overview of a patient’s Home meds (i.e. pre-
admission medication), current medications (i.e. the inpatient chart)
and discharge medications. Home meds are populated from what
has been captured in the medication history taken in the current ad-
mission and current and discharge medications are populated from
what has been prescribed during the current patient admission.
All Meds (across episodes): A view of all medications
prescribed across all admissions in a list view.
Discontinued Meds (all episodes) : A view of all medications
discontinued across all admissions in a list view.
Select each tab and view the medication displayed.
You can also view medication by selecting EPR from the menu head-
er, then select Medication Summary tab.

Prescribing General Regular Medication

Please note: Before prescribing regular medications, you must
record any allergies the patient has within Active Clinical Notes. If the
patient has no allergies this must also be recorded. e.g. No known
allergies. (see Add an Allergy)
Within the Active Clinical Notes Select the Medication
Summary icon.
On the Medication Admin Chart hover over Admin and select New
Order.

PAGE 24

Medicines / Drug Charts Cont.

The Orders pane displays:-

Select the appropriate Medication Item tab and enter the first few char-
acters of the medication name in the Item field.
Any corresponding medications display in the Item lookup. If you want
to search by brand rather than generically (useful for drugs like Adcal
D3 and Gaviscon) select it here.

PAGE 25

Medicines / Drug Charts Cont.

Select the appropriate medication, including the correct formulation,
from the options displayed.
If the required item is not visible the accordion

contains additional prescribing information:

Include Non Formulary: If the medication that is required is not

visible the prescribers can choose to search for non-formulary items

also by checking the Include Non-Formulary checkbox. Do not do this

routinely as the formulary status gives an indication of what is likely to

be available in the hospital and reduces options hence reducing

selection errors.

The medication displays in the main pane and the Scratchpad pane.

In the main pane, below the green banner containing the name of the
medication, complete all the necessary details in the Medication Order
Details accordion. For inpatient prescribing select a priority of
Normal Priority
Other Duration Fields needing
completion

Normal For inpatient prescriptions

Discharge For discharge medications

STAT For one dose now

Once Only For one dose at specified time

Emergency/ASAP For use in emergency department

PAGE 26

Medicines / Drug Charts Cont.

Also enter the dose, frequency and duration, as appropriate.
The Dose field is numeric only. Enter the numbers of the dose in this
field and the units (e.g. mg, tablets etc.) using the Lookup. N.B. Dose
ranges can be prescribed by putting the maximum dose in the Dose
box and the minimum dose in the Minimum dose box.

The Frequency selected is set to a
defined time(s). Once a day defaults
to morning, so if you want the item
to be given at another time of day
select the correct one (e.g.
lunchtime, evening, night). Similarly
use meal times for insulin and oral
antidiabetic drugs rather than twice
a day, etc.

When a weekly, twice weekly or three times frequency is selected from
the Frequency lookup, the days of the week checkboxes will appear.
The required number of days per week are checked by default,
however the prescriber can amend the required days as appropriate.

For items being prescribed every X hours (e.g. fentanyl every 72 hours,
MST Continuous every 12 hours, Oramorph every 2 hours) enter this in
the Every field rather than selecting a frequency.

For PRN medications tick the PRN checkbox. This generates a PRN
Indication For field in the Other Medication Details accordion, which
must be completed before clicking the Update button.

The selection made in the Duration Options field - determines whether
the other duration fields display. Use Ongoing as the default for all
medication for which there is not a defined end date. Use For if it is a
short course. Do NOT use Event.

PAGE 27

Medicines / Drug Charts Cont.

Duration Option Other Duration Fields needing
completion
Event Event free text box
For
Duration number and duration unit
Ongoing fields
Until N/A

Order End Date

Some medications may display information and guidance in the order
notes and progress notes fields within the Other Medication Details
accordion.

The Order notes field is a free text box which can be used to enter
information which will appear on the medication chart.
Check that all the details have populated correctly.
When all the details are correct, click the Update button in the main
pane. The main pane clears and the medication details update in the
Scratchpad.

For prescribed medications the Stat icon displays. This enables a

Stat dose to be easily added to the prescribed order. This is particularly

useful if the next dose isn’t due until the next morning but you would like

one to be given today. Continue to prescribe any further medications for

the patient.
When all the required medications have been added to the Scratchpad,
click the Update button in the Scratchpad.

If there are any interactions or warnings they will appear at this stage.
Ensure you read them and act on them appropriately, indicating the rea-
son for overriding them.

The prescribing window closes and the medications display in a
Confirmation pane.

PAGE 28

Medicines / Drug Charts Cont.

This is your last chance to change anything. If you are happy enter your
password details and click the Update button. The medications have
been prescribed and the Home page displays.

To view the prescribed medications view the Current Medications accor-
dion in Active Clinical Notes, the Medication Summary icon in Active
Clinical Notes or the Medications Summary tab of the EPR.

Variable Dose Prescribing

Select the Medication Summary icon .

Select Admin > New Order. The Orders pane displays:-

Select the appropriate Medication Item tab and enter the first few char-
acters of the medication name in the Item lookup.

PAGE 29

Medicines / Drug Charts Cont.

Any corresponding medications display in the lookup. Select the appro-
priate medication, including the correct formula, from the options dis-
played. The medication displays in the main pane and the scratchpad
on the right.
Complete the two Dose fields, Frequency field and Duration field with
the details required during the initial administrations. For variable doses
with specific end dates (e.g. reducing courses of prednisolone) the full
course length could be selected at this point.
The Administration times display below the Frequency field.

Select the Dosing Model hyperlink. The Dosing Model window opens:-

Select the Calendar tab.

PAGE 30

Medicines / Drug Charts Cont.

To change a dose after a few days, amend the entry in the Dose
Quantity box then select Apply to Doses check box.

This changes all the subsequent doses to the new dose.

Repeat for all known dose changes. Click the Update button in the
Dosing Model window.

The Dosing Model window closes and the main pane displays.

Continue to prescribe the medication as per the steps outlined in the
Prescribing General Regular Medication section.

The medication is prescribed.

Prescribing a maintenance dose after a
reducing dose

For inpatient prescriptions, prescribe the full reducing course. Prescribe
the maintenance dose to start once the reducing course is complete.

For discharge prescriptions the same can be done as long as the start
date for the maintenance dose is clearly documented in Order Notes.
An alternative way is to prescribe the maintenance dose as the last
variable dose and indicate clearly in the Instruction box that this is the
maintenance dose.

PAGE 31

Medicines / Drug Charts Cont.

Discontinuing a Medication

Select the Active Clinical Notes menu item and select the Meds
icon. The medication charts display.
Select the Current Medications tab. The current medications display.
Tick the box next to the medication that needs to be discontinued. The
checkbox is ticked and the medication row highlights in yellow.
From the Admin drop-down, select Discontinue The Discontinue window
opens. Complete all the necessary fields and click the Update button.
The medication no longer displays in the Current Medications pane.
To view the discontinued medications view the Discontinued Meds tab
in the Medication Summary Charts.

Modifying a Medication

Select the Active Clinical Notes menu item and select the Meds
icon. The medication charts display.
Select the Current Medications tab. The current medications display.
Select the generic drug name hyperlink. The order details screen opens
up.
Change the medication details as required. Enter a modification reason
then click Update.
The Modification window closes.
The medication has now been modified.

PAGE 32

IT Training SharePoint Page access

You can book on to a clinical TrakCare session by opening Internet
explorer, then selecting SharePoint tab and then IT training site.

On main page, click book IT Training. You will find dates of when
sessions are planned and a booking form link at the top of the page.
Click here to access page
You can complete training via eLearning module by opening Internet
explorer, then selecting SharePoint tab and then IT training site. On
main page, click Doctors Induction E-learning. You will find all of the
mandatory packages near the top of the page.
Click here to access page
You will need to complete :
 ICE, PACS and NHTop e-Learning
 Clinical TrakCare Inpatients and Outpatients e-Learning
 TrakCare Theatre (in surgery) e-Learning
 TrakCare EPMA module 1 and module 2 e-Learning

(covers electronic medicines)

PAGE 33

Electronic Staff Record (ESR)

You can log on to ESR via this link:
https://www.nth.nhs.uk/jobs/my-esr/

Use your ESR username and
password to get access to ESR.
Your username will always have “345” before it. The password will
need to be updated every 90 days.

From the dashboard you can access the guides necessary to use ESR
effectively. Underneath the “Local Links” section at the bottom of the
dashboard you can find the following guides:-

How to Access ESR E-Learning Guide – Although most of your e-
Learning will be available for you to complete straight away, you may
be required to subscribe and enrol onto some additional courses. This
guide teaches you how to set up your e-Learning.

How to Renew E-Learning Guide – When you need to complete e-
Learning for a second time i.e. when a yearly compliance elapses, you
will be required to renew your e-Learning. This guide teaches you how
to renew your e-Learning.

If you have any issues regarding ESR please contact
[email protected]