Create a New Physician Card

You can create a new physician card either from the main Investigations tab page in Sentinel or from the Physician Reporting menu in the Physician Card Data Entry application, depending on your user access level and permissions.

To create a new physician card in Sentinel, first click the Home > Investigations tab, then click the New button. Select the Physician Card option from the New Investigation drop-down list. Enter the parameters and click Validate and Save. The Case Reporting tab page opens with the physician information pre-populated on the Create New Physician Card page. Enter any information on any of the tab pages and click Submit Changes. See View/Edit Case Details for more information.

If you are using the Physician Card Data Entry application, there are two ways to create a new physician card, and both are located on the Physician Reporting menu. Select either Physician Reporting > Physician Card Listings or Physician Reporting > Physician Card. Enter the information and click Validate and Save. The Successful Submission pop-up window opens. Click either the Logout, Submit a New Report, or Go to Case Listings button to continue. Click the X button to return to the Physician Card List page.

Field/Option

Description

Patient Name

Last Name

Enter the last name of the patient. This field is required.

First Name

Enter the first name of the patient. This field is required.

Middle Name

Enter the middle name of the patient.

Is the patient hospitalized for this illness?

Select No, Unknown or Yes from the drop-down list.

Medical Record Number

If Is the patient hospitalized for this illness field is set to Yes, enter the medical record number.

Patient Address

Street1

Enter the first line of patient's address. Maximum of 30 characters.

Street 2

Enter the second line of patient's address. Maximum of 30 characters.

State

Select the patient's state from the drop-down list. The default is set to the home state of the user.

NOTE: If out of the home state of the user is selected, the County field is disabled.

City

Enter the patient's city. First, select a state, and then type the first four letters of the city name; a pop-up list of city names and zip codes appears. Select the city name and zip code from the list. The City, Zip code, and County fields populate with the stored information.

Zip

Enter the patient's zip code. This field is automatically populated by selecting the City field.

County

Select the county from the drop-down list. This field is automatically populated if one county is located in the selected city.

Patient Phone Number/SSN

Home Phone

Enter the patient's home phone number.

Ext.

If applicable, enter the patient's home phone extension.

Work Phone

If applicable, enter the patient's work phone number.

Ext.

If applicable, enter the patient's work phone number extension.

SSN

Enter the patient's social security number including the dashes.

Patient Date of Birth

Date of Birth

Click in the field to enter the patient's birthdate or select it from the calendar pop-up. If the birthdate is not known, enter the Age and Age Unit. This field is required if Age is not available.

Age

Enter the patient's current age. If the birthdate is entered, this field is automatically calculated and disabled. This field is required if the birthdate is not entered.

Age Unit

Select the unit of the current age. If the birthdate is entered, this field is automatically calculated and disabled.

Was this a child enrolled in a daycare center?

Select No, Unknown or Yes from the drop-down list.

Sex

Select the gender of the patient from the drop-down list. This field is required.

Ethnicity

Select the ethnicity of the patient from the drop-down list.

Race (Select All That Apply)

Select this option for one or more races. The default is Unknown. This field is required.

Pregnant During Illness

Select No, Unknown, or Yes from the drop-down list.

if yes EDC or Delivery Date

If Yes is selected in the Pregnant During Illness field, then click in the field and enter the date or select the EDC or delivery date from the calendar pop-up. Today's date is the default date.

EDC or Delivery Date Type

Select the type of date from the drop-down list. This field is required, if EDC or Delivery Date is specified.

Occupation (Select All That Apply)

Select one or more occupations from the drop-down list. If Other is selected, a description is required in the next field.

Other (specify)

Enter a description if Other is selected in the Occupation field.

Field/Option

Description

Disease Name

Select the disease name or the reportable condition from the drop-down list. This field is required. Examples: Anthrax, Botulism - Food borne, Brucellosis. These diseases/conditions are maintained by the System Administrator.

NOTE: The disease name determines the other fields that appear. Example: If the disease is Hepatitis, Tuberculosis, or Gonorrhea, extra fields specific to the disease appear on the page.

Hepatitis - displays Hepatitis Specific Information and Hepatitis Chemistry Results
Tuberculosis - displays Mycobacterial Disease Information
Gonorrhea, chlamydia, or syphilis (including congenital) - displays Treatment Information
Lyme Disease (State-configurable option) - displays Lyme Disease Information

Onset Date

Click in the field to enter the date or select the date the symptoms of this disease first appeared from the calendar pop-up. Today's date is the default date.

Method of Diagnosis

Select one of the following methods of diagnosis from the drop-down list. This field is required.

Clinical
Laboratory
Both Clinical or Laboratory

NOTE: If the Method of Diagnosis is Laboratory or Both Clinical and Laboratory, then the Serology fields in the Lab Test Results section are enabled.

Diagnosis Date

Click in the field to enter the date this disease was diagnosed or select the date from the calendar pop-up. Today's date is the default date.

To display this section on the page, click the header. You can add details for up to three lab test results.

Field/Option	Description
Laboratory Name	Enter the first four letters of the laboratory name; a pop-up list of laboratory names appears. Select the name of the laboratory from the list. This field is required for the first lab test results, when the Method of Diagnosis field is set to Laboratory or Both Clinical and Laboratory.
Specimen Source	Select the type of specimen collected from the drop-down list. This field is enabled when you enter a name in the Laboratory Name field.
Date Specimen Obtained	Click in the field to enter the date the specimen was obtained or select the date from the calendar pop-up. Today's date is the default date. This field is enabled and required when you enter a name in the Laboratory Name field.
Test Name	Select the test name from the drop-down list. This list is derived from the lab observation table. This field is enabled and required when you enter a name in the Laboratory Name field.
Test Result	Select the test result from the drop-down list. This field is enabled and required when you enter a name in the Laboratory Name field.

This section is enabled if the Method of Diagnosis field is set to Laboratory or Both Clinical and Laboratory.

Field/Option	Description
Test Result	Enter the description of a reported observation. Test results are a non-standard representation of the observation.
Numeric Result	Enter a means of capturing the measured values of the test outcomes in a standard way.
Comments	Enter any comments about the reported observation.

Field/Option	Description
Title	The name title of the person providing the disease report. This is a read-only field in Physician Card Data Entry application.
Last Name	The last name of the person providing the disease report. This field is automatically populated from the user ID information unless it was changed by the user. This is a read-only field in Physician Card Data Entry application.
First Name	The first name of the person providing the disease report. This field is automatically populated from the user ID information unless it was changed by the user. This is a read-only field in Physician Card Data Entry application.
Name of Hospital, Clinic Etc	The name of the hospital, clinic, etc. providing the disease report. This is a read-only field in Physician Card Data Entry application.
Phone	The phone number of the person providing the report. This field is automatically populated from the user ID information unless it was changed by the user. This is a read-only field in Physician Card Data Entry application.
Ext.	If applicable, the phone number extension of the person providing the report. This field is automatically populated from the user ID information unless it was changed by the user. This is a read-only field in Physician Card Data Entry application.
Email	The email address of the person providing the report. This field is automatically populated from the user ID information unless it was changed by the user. This is a read-only field in Physician Card Data Entry application.

Field/Option	Description
Title	Enter the title of the attending physician.
Last Name	Enter the last name of the attending physician. Type the first four letters of the last name; a pop-up list of the full name and facility name appears. Select the name and facility from the list. Maximum of 30 characters.
First Name	Enter the first name of the attending physician. Type the first four letters of the first name; a pop-up list of the full name and facility name appears. Select the name and facility from the list. Maximum of 30 characters.
Date of Report	The referral date. The default date is today's date. This field is automatically populated with the Referral Date on the Case Reporting tab page of Sentinel. This is a read-only field in Physician Card Data Entry application.
Facility	The name of the facility. This field is automatically populated when you select the name of the attending physician.
Phone	The phone number of the attending physician. This field is automatically populated when you select the name of the attending physician.
Ext.	If applicable, the phone number extension of the attending physician. This field is automatically populated when you select the name of the attending physician.
Email	The email address of the attending physician. This field is automatically populated when you select the name of the attending physician.
Street 1	The first line of the attending physician's address. This field is automatically populated when you select the name of the attending physician. Maximum of 30 characters.
Street 2	The second line of the attending physician's address. This field is automatically populated when you select the name of the attending physician. Maximum of 30 characters.
State	The state name of the attending physician's address. This field is automatically populated when you select the name of the attending physician.
City	The city of the attending physician's address. This field is automatically populated when you select the name of the attending physician.
Zip	The zip code of attending physician's address. This field is automatically populated when you select the name of the attending physician.
County	If necessary, select the attending physician's county from the drop-down list. Otherwise, this field is automatically populated when you select the name of the attending physician.

To display this section on the page, click the header. Enter any comments or additional information regarding the physician.

This section is displayed when any Hepatitis condition is selected in the Disease Name field in the Disease or Condition Information section. The Hepatitis Laboratory Information and Hepatitis Chemistry Results sections then appear.

Field/Option

Description

Laboratory Name

Enter the first four letters of the laboratory name where the tests were performed and the results were obtained; a pop-up list of laboratory names appears. Select the name of the laboratory from the list. Once you enter the laboratory name in the field, the remaining fields available in this section are enabled.

Specimen Source

Select the type of specimen collected from the drop-down list.

Date Specimen Obtained

Click in the field to enter or select the date specimen was obtained from the calendar pop-up. Today's date is the default date.

Hepatitis A IgM antibody

Select one of the following results from the drop-down list:

Negative
Not Done
Pending
Positive
Unknown

NOTE: This field populates the Test Name and Result descriptions in the Observations section on the Lab Reports tab in Sentinel.

Hepatitis B IgM core antibody

Select one of the following results from the drop-down list:

Negative
Not Done
Pending
Positive
Unknown

NOTE: This field populates the Test Name and Result descriptions in the Observations section on the Lab Reports tab in Sentinel.

Hepatitis C antibody

Select one of the following options from the drop-down list:

Negative
Not Done
Pending
Positive
Unknown

NOTE: This field populates the Test Name and Result descriptions in the Observations section on the Lab Reports tab in Sentinel.

Jaundiced

Select No, Unknown, or Yes from the drop-down list to indicate whether the patient is jaundiced.

NOTE: This field automatically populates the supplemental form.

Field/Option

Description

Laboratory Name

Enter the first four letters of the laboratory name where the tests were performed and the results were obtained; a pop-up list of laboratory names appears. Select the name of the laboratory from the list. Once you enter the Laboratory Name in the Laboratory Name field, the fields available in this section are enabled.

Specimen Source

Select the type of specimen collected from the drop-down list.

Date Specimen Obtained

Click in the field to enter the date or select the date specimen was obtained from the calendar pop-up. Today's date is the default date.

Date of Chemistry Test

Click in the field to enter the date or select the date of the chemistry test from the calendar pop-up. Today's date is the default date.

Total Bilirubin

Enter the value of the total bilirubin.

NOTE: This field automatically populates the supplemental form.

Normal Range

Enter the value of the normal range for the bilirubin test.

NOTE: This field automatically populates the supplemental form.

SGOT(AST)

Enter the value of the SGOT(AST).

NOTE: This field automatically populates the supplemental form.

Normal Range

Enter the value of the normal range for the SGOT(AST).

NOTE: This field populates the Test Name and Result descriptions in the Observations section on the Lab Reports tab in Sentinel and the supplemental form.

SGPT(ALT)

Enter the value of the SGPT(ALT).

NOTE: This field populates the Test Name and Result descriptions in the Observations section on the Lab Reports tab in Sentinel and the supplemental form.

Normal Range

Enter the value of the normal range for the SGPT(ALT).

NOTE: This field populates the Test Name and Result descriptions in the Observations section on the Lab Reports tab in Sentinel and the supplemental form.

This section is displayed when the Tuberculosis condition is selected in the Disease Name field in the Disease or Condition Information section. The Mycobacterial Disease Information section appears. The available fields and options on this section are as follows:

Field/Option

Description

PPD Mantoux Date

Click in the field to enter or select the PPD mantoux date from the calendar pop-up. Today's date is the default date.

PPD Mantoux Size (mm)

Enter the size of the PPD mantoux in millimeters. Maximum of 30 characters.

IGRA Date

Click in the field to enter or select the IGRA date from the calendar pop-up. Today's date is the default date.

IGRA Results

Select one of the following IGRA results from the drop-down list:

Indeterminate
Negative
Not Done
Positive
Unknown

Sputum Date

Click in the field to enter or select the sputum date from the calendar pop-up. Today's date is the default date.

Sputum Test Type

Select one of the following sputum test types from the drop-down list:

Indeterminate
Negative
Not Done
Positive
Unknown

Tissue Test Date

Click in the field to enter or select the tissue test date from the calendar pop-up. Today's date is the default date.

Tissue Test Type

Select one of the following tissue test types from the drop-down list:

Smear
Culture

Body Fluid Date

Click in the field to enter or select the body fluid date from the calendar pop-up. Today's date is the default date.

Body Fluid Test Type

Select one of the following body fluid test types from the drop-down list:

Smear
Culture

Chest X-Ray Date

Click in the field to enter or select the chest X-ray date from the calendar pop-up. Today's date is the default date.

Chest X-Ray Results

Select one of the following chest X-ray results from the drop-down list:

Abnormal
No X-Rays
Normal
Unknown

NOTE: This field automatically populates the supplemental form.

CT Date

Click in the field to enter or select the CT Date from the calendar pop-up. Today's date is the default date.

CT Results

Select one of the following CT results from the drop-down list:

Abnormal
No X-Rays
Normal
Unknown

If Gonorrhea, Chlamydia, or Syphilis (including Congenital), provide the following Treatment Information Section:

This section is displayed when any of the Gonorrhea, Chlamydia, or Syphilis (including Congenital) condition is selected in the Disease Name field in the Disease or Condition Information section. You can add up to five treatments for these diseases. The available fields and options on this section are as follows:

Field/Option	Description
Date Treated	Click in the field to enter or select the treatment date from the calendar pop-up. Today's date is the default date.
Medication was	Select one of the following medication options from the drop-down list: Administered Prescribed Unknown This field is required if the treatment date is entered in the Date Treated field.
Medication	Enter the name of the medicine.
Dosage	Enter the dosage of the medicine.
Route	Select the type of route for the medicine to be taken from the drop-down list: IM IV PO
Frequency	Enter the frequency of the medicine.
Duration	Enter the duration for the medicine.

This section is displayed when the Lyme Disease condition is selected in the Disease Name field in the Disease or Condition Information section. The Lyme: Symptoms And Signs of Current Episode (Please Mark Each Question), Lyme: Other History, and Lyme: Laboratory Results sections appear.

Lyme: Symptoms And Signs of Current Episode (Please Mark Each Question) Section:

Field/Option	Description
Dermatologic
Erythema migrans	Select No, Unknown, or Yes from the drop-down list to indicate the physician diagnosed EM at least 5 cm in diameter.
Rheumatologic
Arthritis Characterized By Brief Attacks of Joint Swelling	Select No, Unknown, or Yes from the drop-down list.
Neurologic
Bell's Palsy or Other Cranial Neuritis	Select No, Unknown, or Yes from the drop-down list.
Encephalitis/Encephalomyelitis	Select No, Unknown, or Yes from the drop-down list.
Radiculoneuropathy	Select No, Unknown, or Yes from the drop-down list.
CSF Tested for Antibodies to B. burgdorferi	Select No, Unknown, or Yes from the drop-down list.
Lymphocytic meningitis	Select No, Unknown, or Yes from the drop-down list.
Antibody to B. burgdorferi higher in CSF than Serum	Select No, Unknown, or Yes from the drop-down list.
Cardiologic
2nd or 3rd Degree atrioventricular block	Select No, Unknown, or Yes from the drop-down list.
Other Clinical	Enter other clinical information.

Field/Option	Description
Antibiotic(s)
Name of Antibiotic(s) Used This Episode	Enter the name of the antibiotic used in this episode.
Use in Days	Enter the number of days the antibiotic is to be taken.
Where was the patient most likely exposed
County	Select the county from the drop-down list.
State	Select the state from the drop-down list.

Field/Option	Description
Serologic test results
EIA/IFA	Select one of the following test results from the drop-down list: Equivocal Negative Not Done/Unknown Positive-IgG Positive-IgM Positive-IgM & IgG
Western blot	Select one of the following test results from the drop-down list: Equivocal Negative Not Done/Unknown Positive-IgG Positive-IgM Positive-IgM & IgG
Culture Results	Select one of the following test results from the drop-down list: Equivocal Negative Not Done/Unknown Positive
Other (Specify)	If applicable, enter the name of the test performed.
Other Result	Select one of the following test results from the drop-down list: Equivocal Negative Not Done/Unknown Positive