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Clinical investigations are the tests and measurements your clinical team performs beyond the basic eye examination - OCT scans, visual field tests, fundus photographs, corneal measurements, and more. Each investigation is ordered from the eye examination record, performed by the ophthalmic technician, and the results are linked back to the patient’s record for the doctor to review and interpret.

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Before You Start

  • Clinical Procedure Templates must be set up for each investigation type your center performs.
  • You need the Healthcare Practitioner role to order investigations.
  • The Nursing User role (ophthalmic technician) is needed to perform and record investigations.

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Step 1: Set Up Clinical Procedure Templates (Admin Task)

Before investigations can be ordered and recorded, each type must have a template. Set these up once.
  1. Go to Healthcare workspace → Consultation Setup card → Clinical Procedure Template → New
Recommended templates for an eye care center:

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Step 2: Order Investigations from the Eye Examination

When the doctor or optometrist orders an investigation during an eye examination:
  1. Open the Patient Encounter
  2. In the Clinical Procedures section, click Add Row
  3. Select the investigation template (e.g., “OCT - Macula”)
  4. Add the service unit where the investigation is performed (e.g., “OCT Suite”)
  5. Save or Submit the encounter
If “Submit Orders on Save” is on, a Clinical Procedure record is created automatically for each ordered investigation.

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Step 3: Create the Investigation Record (If Not Auto-Created)

If the order was not auto-created:
  1. Go to Healthcare workspace → Consultation card → Clinical Procedure → New
Clinical Procedure form showing patient name, procedure template, practitioner, service unit, start date, status, and notes field
  1. Fill in the details:

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Step 4: Perform the Investigation

The ophthalmic technician performs the investigation using the specialist equipment. For OCT:
  1. Open the Clinical Procedure record for this patient
  2. Set status to In Progress
  3. Perform the OCT scan
  4. If the results are captured as an image (most OCT machines export a PDF or image), use the attachment feature to attach the report to the record
  5. Set status to Completed
  6. Submit
For Visual Fields:
  1. Open the Clinical Procedure record
  2. Set status to In Progress
  3. Run the visual field test (Humphrey, Octopus, etc.)
  4. Attach the printout or export file
  5. Set status to Completed
  6. Submit
For Tonometry:
  1. Open the Clinical Procedure record
  2. Record the IOP values in the Notes field (Right Eye: 14 mmHg, Left Eye: 16 mmHg)
  3. Note the method used (NCT, Goldmann, iCare)
  4. Set status to Completed
  5. Submit

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Storing Investigation Results as Diagnostic Reports

For investigations with more complex results (OCT, fundus photography, FFA, visual fields), use the Diagnostic Report and Observation records for structured result storage.

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Creating an Observation Record for Investigation Results

  1. Go to Healthcare workspace → Diagnostic Module card → Observation → New
Observation form showing patient, observation template, observation category set to Imaging or Exam, and result fields
  1. Fill in:
  1. Submit the Observation

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Creating a Diagnostic Report to Group Observations

If multiple investigations belong together (e.g., OCT disc + OCT macula + visual fields for a glaucoma patient):
  1. Go to Diagnostic Module card → Diagnostic Report → New
  2. Link to the patient and practitioner
  3. Reference the component Observations
  4. Set status to Approved after the doctor reviews the findings

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Observation Templates for Eye Investigations

Set up Observation Templates for structured result recording:

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Field Guide: Clinical Procedure

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Monitoring Investigations

  • Clinical Procedures Status chart on the Dashboard: how many investigations are pending, in progress, or complete
  • Clinical Procedures by Type chart: which investigations are ordered most often
  • Filter the Clinical Procedure list by status = “Pending” to see all outstanding investigations

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Troubleshooting

An investigation record was not created after the examination was submitted Check that “Submit Orders on Save” is enabled in Healthcare Settings. If not, create the Clinical Procedure manually. I cannot attach the OCT report to the Clinical Procedure record The attachment button should be at the bottom of the Clinical Procedure form. If you cannot see it, scroll down or look for the Attach button in the form toolbar. The investigation shows as Completed but the doctor says results are not visible Check that the Clinical Procedure record has been submitted (not just saved). Submitted records appear in the Patient History.

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Best Practices

  • Perform investigations in the order they were listed in the examination - if dilation is needed for some investigations (OCT, fundus photography), do the non-dilated tests first (tonometry, corneal topography) to avoid dilation affecting results
  • Always note the investigation method and equipment in the Notes field - an IOP of 16 mmHg on a Goldmann tonometer means something different from 16 mmHg on a non-contact tonometer
  • For visual field tests, note the reliability indices (fixation losses, false positives, false negatives) - an unreliable field test is not clinically usable
  • Attach the full investigation report PDF rather than just entering a number - the clinical pattern (not just the summary number) is what the doctor needs to see
  • Set up Observation Templates for the key numeric values (RNFL thickness, cup:disc ratio, MD) so these can be tracked over time as trends