TB Program - Staff Portal

Set Your Credentials

Your account requires new credentials before you can continue.

Access Code (optional)

Verify Code (required)

Set Your Electronic Signature

As a provider, you need an electronic signature code to sign orders and clinical documents. This is a legally binding signature — choose something memorable and keep it private.

Current Assigned E-Sig Code

New E-Sig Code (minimum 6 characters)

Confirm E-Sig Code

Change Credentials

Access Code

Verify Code

TB Program – {{ roleLabel }}

{{ user.username }} · {{ user.role }}

Change Credentials

Update access or verify code

Edit Profile

Coming soon

Sign Out

Intake Queue

Patient check-in submissions pending verification

Review Intake Submission

Confirm demographic information before adding the patient to VistA.

Possible duplicate patient found

Review before committing this kiosk intake record. The clerk may continue only after confirming this is a different patient.

Search by

DDI / DFI DATABASE — Clinical Pharmacist Review

Total Entries

HIGH

MODERATE

LOW

Reviewed

Pending

Source: FDA SPL drug labels (automated via Claude Haiku extraction) + CDC/ATS/WHO guidelines (manual curation). All entries should be verified by a clinical pharmacist before production use.
Lipscomb University PharmD Program — Student Review Collaboration

Total Findings

Pending Review

Accepted

Rejected

Literature findings sourced from PubMed, FDA FAERS, DailyMed, and ClinicalTrials.gov via pubmed_agent.py. AI-extracted interactions require PharmD verification before promotion to the DDI database.
Lipscomb University PharmD Program — Student Review Collaboration

PharmD Review

{{ ddiReviewItem.type }}: {{ ddiReviewItem.drugA }} + {{ ddiReviewItem.drugB }}

Severity: {{ ddiReviewItem.severity }}

Mechanism: {{ ddiReviewItem.mechanism }}

Clinical Action: {{ ddiReviewItem.clinicalAction }}

Source: {{ ddiReviewItem.source || 'FDA-SPL' }}

Previous review: {{ ddiReviewItem.reviewStatus }} by {{ ddiReviewItem.reviewedBy }} — {{ ddiReviewItem.reviewNotes }}

Literature Finding Review

PMID: {{ litDetailItem.pmid }} — {{ litDetailItem.sourceDb || 'PubMed' }}

Classification:

Priority: {{ litDetailItem.priority || 'N/A' }}

Drug 1: {{ litDetailItem.drug1 }}

Drug 2: {{ litDetailItem.drug2 }}

Severity: {{ litDetailItem.severity || 'Not specified' }}

Mechanism: {{ litDetailItem.mechanism || 'Not specified' }}

Clinical Action: {{ litDetailItem.clinicalAction || 'Not specified' }}

Confidence: {{ litDetailItem.confidence || 'N/A' }}

Abstract Excerpt

AI Rationale

Previous review: {{ litDetailItem.status }} by {{ litDetailItem.reviewedBy }} — {{ litDetailItem.reviewNotes }}

PharmD Review Decision

SYSTEM ADMINISTRATION

Notifications

Create Patient Record

Possible duplicate patient found

Review these DFNs before creating a new patient record.

Patient Directory

Use last name, first initial, DOB, SSN last 4, or DFN to investigate possible duplicates.

Create New User Account

The user will receive temporary login credentials. On first login they will be required to set a new verify code.

No email yet? After clicking "Create User Account," the temporary access code and verify code will be displayed on screen. You can copy them and provide them to the user directly.

On first login, the user can change their access code and must set a new verify code.

Email delivery uses Microsoft Graph (Outlook). Configure via YDB console:


                      S ^TBP("MSGRAPH_TENANT")="your-tenant-id"

All System Users

No users have been assigned roles yet.

Role-Based Signing & Ordering Authority

In public health, nurses can sign RAT assessments, acknowledge SOAP notes, and order lab tests (e.g., from AEL) — but cannot sign prescription orders. Only providers have prescribing authority. Use the toggles below to customize permissions per user.

Select a user below to view or edit their permissions.

DUZ: {{ u.duz }}

Editing Permissions for DUZ: {{ editingPermsFor }} — {{ allUsers.find(function(u){return u.duz==editingPermsFor}).name }} ({{ allUsers.find(function(u){return u.duz==editingPermsFor}).role }})

Clinical Staff (Nurse + Provider)

Provider Only (Prescribing Authority)

Notification Inbox {{ mailUnread }} unread

No notifications yet.

To: {{ msg.to }} · {{ msg.timestamp }}

                            {{ msg.body }}
                          

Mark as read

{{ searchResults.length }} patient{{ searchResults.length > 1 ? 's' : '' }} found — select one to open the RAT

DOB: {{ formatDob(p.dob) }} · {{ p.sex==='F'?'Female':'Male' }}

DFN: {{ p.id }}

No patients found

Try a different search type or check the value entered

Use the search bar above to find a patient

DOB: {{ formatDob(patient.dob) }} | {{ patient.sex==='F'?'Female':'Male' }} | DFN: {{ patient.id }} | Lang: {{ patient.primaryLanguage }}

CWAD — {{ patient.cwad ? 'ALERTS PRESENT' : 'No Active Alerts' }}

C — Crisis Notes

Mental health crisis documentation on file

W — Warnings

Fall risk or other clinical warnings

A — Allergies

Drug, food, or environmental allergies on file

D — Directives

Advance directives / DNR on file

No Active CWAD Flags

No crisis notes, warnings, allergies, or directives

Reload saved RAT

AI Clinical Update In Progress

{{ aiActivityLabel || 'Refreshing AI-assisted content for the current patient.' }}

Select Encounter Type

Risk Assessment

Complete a TB RAT for new patients or periodic re-evaluation. Includes exposure history, medical risk factors, and symptom screening.

TBI Nurse Visit

TB Infection (TBI) nurse monitoring visit — symptom review, medication adherence, labs, services, and SOAP note.

TBI Clinic Visit

Provider follow-up for TB Infection — review nurse visit summary, physical exam findings, sign updated SOAP note, and adjust treatment plan.

Provider Orders

Place lab, radiology, and pharmacy orders. Review active and pending orders.

eMAR

Medication administration record with patient demographics, active medications, DOT/package tracking, monthly symptom checks, and print-ready MAR grid.

Medical Records

Upload referral scans to secure storage, track source documents, and queue local AI extraction for supervisor review.

Lab Results (AEL)

View inbound results from American Esoteric Laboratories — IGRA, LFTs, AFB cultures, and hepatic panels received via HL7 ORU interface.

Education & Review

Review lab results, view AI-recommended educational videos, and send personalized materials to the patient.

TBD Nurse Visit

TB Disease case management — DOT observation, sputum collection tracking, contact investigation, symptom monitoring, and side effect assessment.

TBD Clinic Visit

TB Disease provider encounter — treatment plan review, sputum conversion tracking, social work coordination, DOT plan, and discharge planning.

Reports

Referral patient registry, date-range and year-to-date filters, outcome metrics, printable spreadsheet view, and CSV export.

AI-Assisted SOAP Note

View the current saved AI-assisted SOAP note for this patient and review the full note history.

TENNESSEE TB ELIMINATION PROGRAM – TB RISK ASSESSMENT TOOL (TB RAT)

H = Hispanic / NH = Non-Hispanic

W=White B=Black A=Asian P=Pacific Islander N=Native American U=Unknown

FOR TARGETED TESTING USE ONLY

RECENT / CURRENT

Foreign-born, high risk areas

Experienced homelessness in past 12 months

Current resident/employee of correctional facility

Current resident/employee of long-term care facility

Injected drugs in past 12 months

Used non-injecting drugs in past 12 months

Heavy alcohol use/abuse in past 12 months

Contact to TB case in past 2 years

Been a child around an adult with a TB risk factor

Lived outside the US for >2 months

EVER

Traveled/resided in high risk area ever

Experienced homelessness ever

Lived/worked in correctional facility ever

Lived/worked in long-term care facility ever

Injected drugs ever

Used non-injecting drugs ever

Heavy alcohol use/abuse ever

Contact to a TB case ever

Been a high-risk health care worker ever

Been a migrant/seasonal worker ever

Diabetes

Silicosis

Leukemia or lymphoma

Cancer of the head and neck or lung

Immunosuppressive condition or therapy

Known HIV

TNF Antagonist therapy

Viral hepatitis (B or C only)

End-stage renal disease

Gastrectomy or jejunoileal bypass

Weigh <90% of ideal body weight

Pre/post organ transplant

Untreated/inadequate TB or TBI treatment

Diagnosed with TB infection (within past 2 yrs)

Other:

Smoking Status:

Previous positive TST

Previous diagnosis of TB disease

Previous completion of therapy for TB disease

HIV risk factors

Previous HIV test

HIV test offered

HIV test performed

Previous positive IGRA

Previous diagnosis of TBI

Previous completion of TBI therapy

PREVIOUS HIV RESULT

CURRENT HIV RESULT

Symptoms present — notify nurse or doctor immediately!

Cough ≥ 2–3 weeks

Weight loss

Hemoptysis

Night sweats

Fever

Other:

Date of symptom onset:

Apply TST or draw IGRA

TB education only

Click to view the full AI-Assisted SOAP Note tab

Counseled on risk of TB disease/infection

TST placed

Read:

Result (mm):

IGRA drawn

COMPLETED BY:

Clicking Sign this report locks these fields and attests that the information is accurate. An addendum is required for any subsequent changes.

Electronically Signed — Record Locked

Remove signature to make corrections before re-signing

Print: {{ rat.f.completedByFirst }} {{ rat.f.completedByLast }}

Signature: {{ rat.f.completedByFirst }} {{ rat.f.completedByLast }}

Date: {{ rat.f.completedDate }}

Electronic signature authenticated by VistA session · DUZ stored in ^TBCLIN

Addendum Signed — Record Locked

Remove addendum signature to make corrections before re-signing

Print: {{ rat.f.updatedByFirst }} {{ rat.f.updatedByLast }}

Signature: {{ rat.f.updatedByFirst }} {{ rat.f.updatedByLast }}

Date: {{ rat.f.updatedDate }}

Addendum 2 Signed — Record Locked

Remove second addendum signature to make corrections

Print: {{ rat.f.updatedByFirst2 }} {{ rat.f.updatedByLast2 }}

Signature: {{ rat.f.updatedByFirst2 }} {{ rat.f.updatedByLast2 }}

Date: {{ rat.f.updatedDate2 }}

ADDENDUM — COMPLETED BY:

ADDENDUM 2 — COMPLETED BY:

Report is signed and saved. Check "Add revision / addendum" to make further changes.

{{ canRunAi ? 'AI analyses the signed RAT and suggests risk level, treatment, and follow-up tests' : aiSoapA ? 'AI report is locked — sign an addendum to re-enable AI analysis' : 'Sign and save the RAT first to enable AI-Assisted SOAP Note' }}

Print the completed RAT Assessment

Generating AI-Assisted SOAP Note

{{ aiActivityLabel || 'Generating the AI-assisted SOAP note from the signed RAT.' }}

RAT Assessment (current)

Go to the AI-Assisted SOAP Note

AI Clinical Analysis in Progress

Reviewing the signed RAT against:

Risk assessment responses & comorbidities
TB exposure, symptoms, and test history
Current provider notes and addenda
Follow-up treatment recommendations
AI-assisted SOAP note synthesis

Estimated time: ~15–25 seconds

Sign the RAT, click SAVE, then click "Get AI-Assisted SOAP Note".

{{ notesFreshForAi ? 'Re-run AI with current provider notes' : rat.f.soapSigLog.length ? 'Enter text as an addendum below to enable Run AI Again' : 'Enter provider notes below to enable' }}

{{ !hasNotes ? (rat.f.soapSigLog.length ? 'Enter text as an addendum below to enable Re-save' : 'Add provider notes below to enable') : (!rat.f.soapProvFirst || !rat.f.soapProvLast) ? 'Enter your first and last name in the signature block to link notes to your account' : 'Save provider notes to VistA' }}

AI-Assisted SOAP Note In Progress

{{ aiActivityLabel || 'Generating the latest AI-assisted SOAP note for the current RAT.' }}

S — Subjective

O — Objective

A — Assessment AI-generated • {{ aiRiskLevel }} RISK

P — Plan AI-suggested

Recommended Clinical Actions

Follow-up Diagnostic Tests

AI-assisted content is advisory only. The treating clinician retains full clinical authority. Provider notes are saved to VistA when RAT is re-saved.

{{ notesFreshForAi ? 'Re-run AI with current provider notes' : rat.f.soapSigLog.length ? 'Enter text as an addendum above to enable Run AI Again' : 'Enter provider notes above to enable' }}

{{ !hasNotes ? (rat.f.soapSigLog.length ? 'Enter text as an addendum above to enable Re-save' : 'Add provider notes above to enable') : (!rat.f.soapProvFirst || !rat.f.soapProvLast) ? 'Enter your first and last name in the signature block to link notes to your account' : 'Save provider notes to VistA' }}

SOAP NOTE — ACCEPTANCE SIGNATURES

{{ idx === 0 ? 'Initial SOAP Note' : 'Addendum ' + idx }} — Signed: {{ entry.sig }} — {{ entry.date }}

S: {{ entry.soapSNotes }}

O: {{ entry.soapONotes }}

A: {{ entry.soapANotes }}

P: {{ entry.soapPNotes }}

{{ rat.f.soapSigLog.length === 0 ? 'Initial Signature' : 'Addendum ' + rat.f.soapSigLog.length + ' Signature' }}

Completed by:

{{ rat.f.soapSigLog.length === 0 ? (hasNotes ? 'Archive your provider notes with your electronic signature' : 'Sign the AI-generated SOAP note as-is — no additional notes required') : 'Archive addendum notes with your electronic signature' }}

{{ rat.f.soapSigLog.length === 0 ? 'Sign the SOAP note first to enable printing' : hasNotes ? 'Re-sign to include your notes, then print' : 'Print signed SOAP note' }}

Go to the RAT Assessment form

AI-Assisted SOAP Note (current)

METRO PUBLIC HEALTH – TBI NURSE VISIT

Symptom key: 0 = Negative + = Positive NA = Not Applicable N = See Notes

VITAL SIGNS

Auto-fill BP, pulse, SpO2, temp, weight from Welch Allyn Connex Spot + Detecto Apex scale

SYMPTOMS

Drugs Dispensed

ELECTRONIC SIGNATURE

{{ !tbi.visitDate ? 'Enter visit date first' : (!tbi.signFirst.trim() || !tbi.signLast.trim()) ? 'Enter your first and last name to sign' : 'Electronically sign this visit — AI assessment will run automatically' }}

VISIT HISTORY (this session)

{{ idx === 0 ? 'Visit' : 'Visit ' + (idx+1) }} — {{ entry.visitDate }}

Signed: {{ entry.date }} • {{ entry.title }}

Save current visit as a draft (does not sign or run AI)

{{ tbiSigLog.length ? 'Print all signed visits for this patient' : 'Sign at least one visit to enable printing' }}

Visit Form (current)

Go to the AI-Assisted SOAP Note

View vitals trend chart

Generating clinical SOAP note…

{{ aiTbiRiskLevel }} RISK

Assessment (SOAP-A)

                    {{ aiTbiSoap }}
                  

Recommendations

AI-generated clinical decision support only. Provider review required before filing. Based on {{ tbiSigLog.length }} signed visit{{ tbiSigLog.length === 1 ? '' : 's' }}.

Sign a visit in Section F to generate an AI-Assisted SOAP note.

Go to the Visit Form

AI-Assisted SOAP Note (current)

View vitals trend chart

Loading vitals history…

Click any legend label to rescale the Y-axis to that vital's range. Showing {{ tbiSigLog.length }} session visit{{ tbiSigLog.length === 1 ? '' : 's' }} + {{ tbiChartData.length }} historical.

Print the vitals trend chart

Active scale: {{ tbiActiveVital }} — historical data loaded from VistA via GET /api/patient/:id/tb/tbi/history

Go to the Visit Form

Go to the AI-Assisted SOAP Note

Vitals Chart (current)

TBI CLINIC VISIT — {{ patient ? (nameFirst(patient.name) + ' ' + nameLast(patient.name)) : '' }}

This is a read-only summary of the most recent TBI Nurse Visit. Edit the original visit to make changes.

Notes: {{ tbi.sxNotes }}

{{ sig.date || sig.visitDate }} — {{ sig.sig || 'signed' }} ({{ sig.role || 'nurse' }})

No nurse visit signatures on record.

AI-Generated SOAP Note

{{ tbiClinicAiSoap }}

Complete the Physical Exam tab, then click "Update AI-Assisted SOAP" to generate.

TBD NURSE VISIT — TB DISEASE INTAKE / CASE MANAGEMENT — {{ patient ? (nameFirst(patient.name) + ' ' + nameLast(patient.name)) : '' }}

TB Disease administrative forms require nurse or administrator access.

New Pt to Do List

Purpose

Information to disclose

Other Medical Conditions

Other Medications

Barriers

Assessment

S/S

Reactions to Meds

Directly Observed Therapy (DOT)

TB Disease AI Evaluation

Temporary decision-support review from de-identified monthly assessment, DOT, barrier, social, and plan context. It is not filed to the patient record.

TB Disease patients still use the existing RAT as the source of truth for TB risk factors. This tab links back to the latest saved RAT without duplicating its fields.

Latest RAT Snapshot

Risk level: {{ rat.f.riskLevel || aiRiskLevel || 'Not recorded' }}

Signed: {{ rat.f.isSigned ? 'Yes' : 'No' }}

Completed by: {{ (rat.f.completedByFirst + ' ' + rat.f.completedByLast).trim() || 'Not recorded' }}

Completed date: {{ rat.f.completedDate || 'Not recorded' }}

TBD CLINIC VISIT — TB DISEASE FOLLOW-UP — {{ patient ? (nameFirst(patient.name) + ' ' + nameLast(patient.name)) : '' }}

Visit type

Review of Systems

Medications

Physical Exam

Generate a temporary SOAP draft from structured TB Disease data. It is filed to TIU/SOAP history only after staff review and electronic signature.

PROVIDER ORDERS (CPOE) — {{ patient ? (nameFirst(patient.name) + ' ' + nameLast(patient.name)) : '' }}

Select medications in Place New Orders first

Open the current saved AI-assisted SOAP note

Primary ICD-10-CM Diagnosis

Search by code or description, then select the primary diagnosis for this order batch. This is required before lab, radiology, or medication orders can be submitted.

Laboratory

Radiology

Pharmacy

Medication orders require prescribing authority. Contact a provider or administrator to place pharmacy orders.

Default adult doses are shown here. Check Customize beside a selected medication only when the provider needs a non-default product, tablet count, or dosing instruction.

Nurse-facing order text

CLINICAL SAFETY ALERTS

PATIENT ALLERGIES ON FILE: Review VistA allergy profile before prescribing.

{{ alert }}

* CDC/ATS TB Treatment Guidelines — local clinical decision support rules
* Source: FDA SPL drug labels / ^TBDDI deterministic database

Drug interactions detected — review before signing

No drug interactions identified in local database

WK Lexidrug commercial DDI integration — pending vendor response

Checking drug interactions… {{ newOrders.labs.length + newOrders.rad.length + newOrders.meds.length }} order(s) selected

AI-GENERATED EVALUATION — This analysis is for clinical decision support only. All assessments must be independently verified by a qualified healthcare provider before clinical action. This evaluation is temporary and will not be retained after the session ends.

AI Clinical Analysis in Progress

Reviewing {{ aiEvalMeds ? aiEvalMeds.split('|').length : newOrders.meds.length }} medication(s) against:

RAT risk assessment & comorbidities
TBI visit history & current medications
DDI database (FDA SPL / ^TBDDI)
Pending literature findings
CDC/NTCA TB treatment guidelines

Estimated time: ~15–25 seconds

Print evaluation (includes disclaimer)

{{ aiEvalText }}

Orders Signed & Submitted

Generate a comprehensive SOAP note integrating all patient data with signed orders

AI-generated SOAP note — must be reviewed and co-signed by a qualified provider.

{{ decodeSoapText(aiSoapText) }}

Select medications in the "Place New Orders" tab to generate an AI evaluation

The AI will analyze proposed medications against the patient's complete clinical context

Active & Pending Orders

{{ selectedActiveOrders.length ? 'Delete selected orders' : 'Delete all unsigned pending orders' }}

Refresh order status from VistA

Existing Prescriptions Current medication records already on file for this patient.

Refresh

MEDICATION ADMINISTRATION RECORD (eMAR)

The eMAR is pre-populated from the patient's active prescriptions and TB medication orders. The upper box cycles through blank, PKG, DOT, and SA for package, directly observed therapy, and self-administered doses. The lower box records the logged-in nurse's initials and is included in the saved MAR snapshot audit.

Medication / Order	Start	Schedule	Mode	{{ day }}
{{ row.drug }} {{ row.dose }} {{ row.route }}	{{ row.startDate \|\| '' }}	{{ row.schedule \|\| '' }}	{{ row.mode \|\| 'DOT' }}	{{ row.days[day] \|\| '' }} {{ row.initials[day] \|\| '' }}
No active medication orders or prescriptions found for this patient.

Monthly Symptom / Toxicity Assessment

Assessment	{{ day }}
{{ sx }}	{{ emarSymptoms[sx][day] \|\| '' }}

SECURE MEDICAL RECORDS — {{ patient ? (nameFirst(patient.name) + ' ' + nameLast(patient.name)) : '' }}

Available Documents

Medical record upload is restricted. Contact a supervisor to add outside records.

Upload Referral / Outside Record

Files are stored in the private GCS bucket. VistA stores only the document pointer, hash, source, and review status.

Uploaded Documents

{{ documentAiResult }}

EXTERNAL LABORATORY RESULTS (AEL) — {{ patient ? (nameFirst(patient.name) + ' ' + nameLast(patient.name)) : '' }}

American Esoteric Laboratories (AEL)

Results received via Mirth Connect HL7 ORU interface. AEL transmits results within 2–4 hours of specimen accessioning. Reference lab: American Esoteric Laboratories, Memphis, TN (Sonic Healthcare).

* Results received securely via Mirth Connect (NextGen Connect) HL7 v2.5.1 ORU interface from American Esoteric Laboratories (AEL / Sonic Healthcare). LOINC-coded.

PROVIDER REVIEW & PATIENT EDUCATION — {{ patient ? (nameFirst(patient.name) + ' ' + nameLast(patient.name)) : '' }}

Laboratory Results — Sputum AFB, LFTs, HIV Screening

Lab Review Required — Abnormal results detected. Review results below before sending education materials to the patient.

AI Education Recommendation

Lab review required before sending to patient

Review lab results first

Additional Resources — Select to include with patient materials

No education data loaded. Click Refresh on the Labs tab.

AI-GENERATED SOAP NOTE — This note was generated by AI clinical decision support and must be reviewed by a qualified healthcare provider. All clinical assessments, diagnoses, and treatment plans require independent verification before clinical action.

Loading AI-Assisted SOAP Note...

Retrieving patient encounter data
Loading SOAP note history
Formatting clinical documentation

Estimated time: ~5–10 seconds

No AI-Assisted SOAP note found for this patient

Generate one from the RAT AI tab or after signing provider orders to begin the saved SOAP-note history

AI-ASSISTED SOAP NOTE — {{ patient ? (nameFirst(patient.name) + ' ' + nameLast(patient.name)) : '' }}

Add a provider addendum to the current SOAP note

Print SOAP note (includes disclaimer)

Provider Addendum for Current SOAP Note

Enter only the new update. The signed addendum will be appended to the current SOAP note and saved into the SOAP-note history.

Addendum Signature:

{{ !aiSoapHasAddendumText ? 'Enter addendum text to enable signing' : (!aiSoapAddendumFirst || !aiSoapAddendumLast) ? 'Provider signature name is required' : 'Append this signed update to the current SOAP note' }}

{{ decodeSoapText(aiSoapNoteText) }}

SOAP Note History

{{ aiSoapNoteHistory.length }} note(s)

Date

Reason

Updated By

Source

Status

Return to the latest SOAP note

Print this SOAP note

{{ decodeSoapText(h.note) }}

REPORTS — REFERRAL PATIENT REGISTRY

Send Education Materials to Patient

Sending to {{ patient ? (nameFirst(patient.name) + ' ' + nameLast(patient.name)) : '' }}

Materials to Send

{{ educationData && educationData.additional_resources ? educationData.additional_resources[idx].title : '' }}

New User Created — Login Credentials

{{ lastTempCode.name }} has been created as {{ lastTempCode.role }}.

Access Code

                {{ lastTempCode.access || '—' }}
              

Verify Code

                {{ lastTempCode.verify || '—' }}
              

Electronic Signature Code

                {{ lastTempCode.esig }}
              

Provider should change this on first login

Provide these credentials to the user directly or via email. On first login, the user can set a new access code and must set a new verify code.

Email will be sent to: {{ lastTempCode.email }} (if Microsoft Graph is configured)

Clinical Order Review

{{ esigDialogData ? ((esigDialogData.labsSaved||0) + (esigDialogData.radSaved||0) + (esigDialogData.medsSaved||0)) : 0 }} order(s) pending — awaiting electronic signature ({{ esigDialogData.vistaFiled }} filed to VistA File #100)

Order Summary

Diagnoses

{{ dx.code }} — {{ dx.description }} [primary]

{{ esigDialogData.vistaFiled }} order(s) filed to VistA OE/RR (File #100)

System-Generated Summary

{{ esigDialogNote || 'Loading summary...' }}

Refer to the AI Evaluation tab for AI-powered clinical insights, drug interaction analysis, current literature findings, and proposed treatment recommendations.

Orders are pending. To activate, go to Active / Pending Orders and sign with your electronic signature.

Cancel submitted orders and go back to modify selections

Proceed to Active / Pending Orders to sign

Sign & Submit Pending Orders

{{ signDialogCount }} pending order(s) will be electronically signed and submitted for processing.

Legal Notice: By entering your electronic signature code, you attest that you have reviewed the clinical decision support note and all pending orders. This constitutes a legally binding electronic signature under 21 CFR Part 11.

Click the eye icon to verify your entry. Orders will be transmitted to the reference laboratory upon signing.

By clicking Sign & Submit, you electronically attest that you have reviewed the pending orders and clinical decision support note. This constitutes your electronic signature.