Using FastForward

Before you start

FastForward lives in a panel along the right-hand side of Chrome. Click the FastForward arrows icon in your toolbar to open it.

It does two jobs on the note you have open in Practice Fusion:

• Set encounter fills in a note from one of your encounter types — its quality-of-care answers, diagnoses, care plan and SOAP templates — and saves it.
• Copy Previous Encounter brings the sections you choose forward from one of the patient's earlier SOAP notes.

The pictures in this guide use made-up encounter types. The numbered yellow badges were added for this guide; you won't see them in the panel.

Signing in

1. Email — the address you subscribed with.
2. Password — the FastForward password you set after subscribing. This is not your Practice Fusion password.
3. Sign in — or press Enter in the password box. Your encounter types load straight away.
4. Sign up — opens our website so you can subscribe.
5. Forgot password? — opens a page where we email you a link to set a new one.

You stay signed in until you sign out, or until you sign in on another computer: an account works on one computer at a time.

If your license isn't active

1. Get a license — opens our website to subscribe or renew.
2. Try again — back to the sign-in panel.

The same panel appears, saying Login failed. Need an account?, when an email and password aren't recognised.

If your changes haven't reached the server

Every change to your encounter types is kept on this computer first, then sent to our server so it follows you to your other computers. If sending fails — no internet connection, or the server can't be reached — a notice at the top of the main panel says since when your changes have been waiting. They are safe on this computer, and FastForward sends them as soon as it can: when you open the panel, every minute while it is open, and before each Set encounter or Copy Previous Encounter.

• Retry now — sends them straight away. The notice disappears once they arrive.

If you sign in while this computer still holds changes that never arrived, FastForward asks before replacing them with the server's copy:

• Keep this computer's types — they become your encounter types everywhere, and are sent to the server.
• Use the server's types — the changes on this computer are discarded.

If your encounter types are locked

Your encounter types are encrypted with a key made from your password. After you reset a forgotten password, any computer you have signed in on before unlocks them again without asking. On a computer that can't, the panel says Your encounter types are locked:

• Cancel — changes nothing. If you have used FastForward on another computer, sign in there first; it unlocks your encounter types, and this computer can then sign in normally.
• Start with default types — replaces your locked encounter types with the standard ones. We can't recover the locked ones. If you have a file from Save types..., bring your own back with Import types....

The main panel

1. Select Encounter Type — the encounter type Set encounter will use. Click the box to see every type, or type part of a name to narrow the list ("pain" finds Back pain, Chest pain and Abdominal pain; capitals don't matter). Pick with the mouse, or with the arrow keys and Enter; Escape keeps the type you had. The type you last used for Set encounter is at the top of the list, with the rest in their usual order. That is saved with your account, so it follows you to any computer you sign in on. FastForward remembers your choice.
2. Delete... — deletes the selected encounter type, after asking you to confirm. See Deleting and backing up.
3. Edit/Copy... — opens the selected encounter type to edit it, or to copy it as a new one. See Editing encounter types.
4. Save types... — saves a copy of all your encounter types to a file on your computer.
5. Import types... — adds the encounter types from a saved file to the ones you already have. See Deleting and backing up.
6. Dx Start Date — the start date given to every diagnosis FastForward enters. It's filled in from the note's date of service when FastForward can read it, otherwise the date you last chose, otherwise today.
7. Dx End Date — when acute diagnoses end: the start date plus the encounter type's Dx duration. Chronic diagnoses have no end date. It's worked out for you; to change it, change the start date or the encounter type's Dx duration.
8. Stage encounter... — the same as Set encounter, but first lets you add or remove Dx codes for this visit only. See Staging an encounter.
9. Set encounter — fills in the open note from the selected encounter type. See Setting an encounter.
10. Copy Previous Encounter to Here... — copies sections from one of this patient's earlier SOAP notes into the open note. See Copying a previous encounter.
11. Sign out — signs you out of FastForward on this computer, and ends the session on our server too.
12. Help — opens this manual in a new browser tab.

Setting an encounter

1. In Practice Fusion, open the patient's chart and the new or unsigned SOAP note you want to fill in.
2. Open the FastForward panel and choose the Encounter Type.
3. Check the Dx Start Date.
4. Click Set encounter.

FastForward then works through the note in this order, and you can watch it happen:

• The three quality-of-care questions are answered, and the seven quality-of-care boxes ticked or cleared, to match the encounter type.
• Each diagnosis is added as Acute or Chronic, following the encounter type's Acuity. An acute diagnosis runs from the Dx Start Date for the encounter type's Dx duration; a chronic one gets the start date and no stop date.
• The care plan section is replaced with the encounter type's care plan.
• Each SOAP section's template is found by name and inserted.
• The note is saved.

When it finishes, Practice Fusion shows Encounter set! You may proceed with editing. and the panel closes.

If a step didn't complete, the message is headed Encounter Set (with problems) and lists what didn't. Check those parts of the note before you sign it.

Staging an encounter

Use this when a visit needs a diagnosis the encounter type doesn't have, or doesn't need one it has. Stage encounter... opens Add Dx to SOAP, holding the selected encounter type's Dx codes. Change the list, then click Set Encounter.

1. ONLY add Dx codes to this SOAP note — tick it to enter just the diagnoses on this list. The templates, quality-of-care answers and care plan are left alone, and the note is saved. It starts unticked each time you open the panel.
2. bubbles | list — how the codes are shown, as on the encounter type editor. Changing it here changes it there too.
3. + — search for codes to add. They go to the front of the list. See Searching for Dx codes.
4. Each code — drag it to change the order the diagnoses are entered in. × takes it off the list for this visit. In list view, the heart beside it adds it to your Favorites, or takes it off again; a filled heart means it's a favorite. That change is kept, unlike the list itself.
5. Set Encounter — exactly what Set encounter on the main panel does, with the same checks, dates, templates, quality-of-care answers and care plan, but entering the diagnoses on this list, in this order, instead of the encounter type's. Each is entered with the encounter type's Acuity.
6. Cancel — back to the main panel. Escape does the same.

Copying a previous encounter

Use this when the patient is back for the same problem and much of the last note still applies.

1. Open the new or unsigned SOAP note you want to copy into.
2. Set the Dx Start Date on the main panel — copied diagnoses start on it.
3. Click Copy Previous Encounter to Here...

FastForward saves your note, then reads the patient's Timeline. Your chart visibly flicks across to the Timeline and back — that's expected.

Choose the earlier encounter

1. The patient's recent SOAP notes — newest first, up to ten, each with its date, visit type and provider, and chief complaint. The note you're on isn't listed. Click one to choose it.
2. Cancel — back to the main panel. Escape does the same.

Choose what to copy

1. The sections — Chief Complaint, Subjective, Objective, Assessment, Plan, Care Plan, and the Quality of care section. All are ticked to start with; untick any you don't want.
2. Diagnoses and Days — copies the earlier note's diagnoses, each keeping its acuity. Acute ones start on the Dx Start Date and run for this many days. Chronic ones keep the start date they had on the earlier note and get no stop date; if that note shows none, they start on the Dx Start Date and the Encounter Copied message lists them. Every diagnosis is copied — remove any that no longer apply. Codes already on the new note are left alone rather than entered twice. FastForward remembers the number of days. Untick Diagnoses and Days greys out.
3. OVERWRITE ANY DATA ON NEW ENCOUNTER! — off, as it starts, copied text is added below whatever each section already holds. On, it replaces it. Diagnoses are always added, and the quality-of-care answers are always set to match, whichever you choose.
4. Continue — copies the chosen sections. The chart detours to the earlier note and back, the copy is written in, and the note is saved. Practice Fusion then shows Encounter Copied, listing what was copied and what was skipped.
5. Cancel — back to the list of earlier encounters. Escape does the same.

Editing encounter types

An encounter type is a saved recipe for one kind of visit: its diagnoses, SOAP templates, care plan and quality-of-care answers. Click Edit/Copy... on the main panel to open the one selected there.

1. New — clears the form to create a new encounter type. The line beneath changes from Currently editing … to Creating new encounter type. Copy, beside it, keeps everything on the form — codes, templates, answers and care plan — and adds -copy to the description (-copy(2), -copy(3) and so on if that name is taken). Change what you need and click Save: it's saved as a new encounter type, and the one you copied is left as it was.
2. Description — the name shown in the encounter type list.
3. Dx codes — the diagnosis codes this type enters. The bubbles | list switch beside the + changes how they're shown. In bubbles, point at a code to see its description and click × to remove it. In list, each code has its own row: a grip (⠿), × to remove it, a heart, the code, then its description. In either view, drag a code to put it in a different place — Set encounter enters diagnoses in this order. Click the heart to add the code to your Favorites — it fills in — or click a filled heart to take it off. Favorites are kept straight away, without Save. FastForward remembers the view you chose on this computer. Click + to search for codes to add. See Searching for Dx codes.
4. Dx duration (days) — how long each acute diagnosis runs from the Dx Start Date. Chronic diagnoses have no end date.
5. Acuity — Acute or Chronic: how each diagnosis this type enters is marked in Practice Fusion. Chronic diagnoses get a start date and no stop date.
6. SOAP templates — the name of your Practice Fusion template for the Subjective, Objective, Assessment and Plan sections. Type each exactly as it appears in Practice Fusion's template search. Leave a box empty to skip that section.
7. Care plan... — the text written into the note's care plan section. See Care plans.
8. Quality of care pulldowns — Yes, No or n/a for each of the three reconciliation questions.
9. Quality of care checkboxes — ticked here means ticked in the note; unticked here means cleared.
10. Save — saves the encounter type to your account, so it's there on any computer you sign in on, and makes it the selected encounter type on the main panel.
11. Cancel — closes the editor without saving. Escape does the same.

Searching for Dx codes

1. Search | Recent | Favorites — where the codes to choose from come from: your search, the codes you've entered most recently, or your favorites. FastForward remembers your choice on this computer.
2. Search ICD-10-CM codes — type at least three characters: a code, a clinical term, or an everyday one such as “pink eye”. Add right, left or both to find side-specific codes. Shown only with Search chosen.
3. Hearts — click one to add that code to your Favorites, or a filled one to take it off. It's kept straight away.
4. Codes to choose from — click a code to add it. Codes already in Added codes are greyed out.
5. Added codes — the whole list you came from, with the codes you pick added at the front, in the order you pick them. Drag a code by its grip (⠿) to move it. Remove takes one off — including one that was already on the list.
6. Done — the list you came from becomes exactly what Added codes shows, and you're back on it. Set encounter enters diagnoses in list order. In the editor, click Save there to keep them.

Recent and Favorites

Recent holds the last 100 different codes that Set encounter and Stage encounter entered, newest first. It fills itself; a code used again moves back to the top. Diagnoses brought across by Copy Previous Encounter aren't added, because they're read from the patient's chart. Favorites holds the codes you've hearted, newest first. Both start empty.

Both are saved with your account, so they follow you to any computer you sign in on. They hold the codes alone — no patient, date or note — and are encrypted on your computer like your encounter types, so we can't read them.

Care plans

Each encounter type can have its own care plan: the patient instructions written into the note's care plan section. A type without one uses our default plan, and keeps up with it when we update it. Click Care plan... in the editor.

1. Custom plan or Using the default plan — whether this type has its own plan. It changes as you type.
2. The plan — line breaks are kept. Leave it empty, or make it the same as the default, to use the default plan.
3. Characters used, out of 4,000. Anything longer is cut to 4,000 and the panel says Care plan maximum length 4000 characters.  Extra characters were lost.
4. Copy plan from... — start from another encounter type's plan, or go back to the default.
5. Done — keeps your changes and returns to the editor. Click Save there to keep them for good.
6. Cancel — discards the changes you made in this panel.

Copy plan from

1. The list — Default plan comes first: choose it to go back to the default. Then every other encounter type, with the first line of its plan, or Uses the default plan. Clicking one replaces the text in the editor; nothing is kept until you click Done and then Save.
2. Cancel — back to the Care plan panel with your text unchanged.

Deleting and backing up

Clicking Delete... on the main panel asks before it deletes anything.

1. Yes — deletes the selected encounter type from your account, on every computer. This can't be undone.
2. No — keeps it.

Saving and importing encounter types

Save types... on the main panel saves every encounter type to a file called diagnosisParams.json on your computer. It holds your encounter types only — no patient information.

Import types... reads a file like that back in. It lists the encounter types it found and waits: Import adds them, Cancel leaves everything as it was. Any encounter type being renamed says so in that list, so a rename is never a surprise. They are added to the ones you already have; nothing is replaced or deleted, and a line under the buttons says how many arrived.

To swap your encounter types for the file's instead — for example to go back to a copy you saved earlier — click Replace all... in that same box. It shows the list again with a warning of how many encounter types will be deleted, and nothing changes until you click Replace all. Afterwards you have exactly the encounter types in the file, under the names the file gives them. Your current encounter types cannot be recovered, so use Save types... first if you might want them.

• Duplicate names are kept, not merged. Importing an encounter type called Strep when you already have one gives you a second one called Strep (2), and the line tells you which were renamed.
• A file that isn't right is refused whole. If any encounter type in it is missing something, nothing is imported and the message says what was wrong. You never end up with half a file.
• Imported encounter types are saved to your account, so they follow you to your other computers.

When something goes wrong

“You must be on a new or unsigned SOAP note to use this feature”

Open the patient's chart, then an unsigned SOAP note, and try again. FastForward won't write to a signed note or to another type of note.

The encounter type list says “Loading encounters...” and never fills in

Close the panel and open it again. If it still doesn't fill in, reinstall using Installing FastForward. Your encounter types are stored with your account and come back when you sign in.

“Signed in on another device. Please sign in again.”

Your account works on one computer at a time, and signing in somewhere else signed you out here. Sign in again.

“Your license isn't active. Get a license to continue?”

Your subscription has ended or a payment didn't go through. Get a license renews it.

“Offline — connect to the internet to use the extension.” or “Connect to the internet to continue.”

FastForward checks your subscription with our server before each action. Reconnect and try again.

A template wasn't inserted

Check that its name in Edit/Copy... matches the template's name in Practice Fusion exactly.

“Couldn't identify this encounter from the page URL”

Open the note from the patient's chart, rather than from a link or a bookmark, and try Copy Previous Encounter again.

“This looks like patient information” when you click Save or Done

Something in the encounter type looks like a patient's name, date of birth or record number, and the warning lists what. Remove it. If it's a false alarm, tick This is not patient information and try again. See Care plans.

“Saved locally, but syncing to the server failed”

Your change is on this computer but hasn't reached your account. Check your connection and click Save again — otherwise it will be replaced the next time you sign in.