Introduction to Commands

Commands are the foundational elements of medical records in Canvas, utilized for both documentation and order placement. Every command needs to be committed in order to be final. In the case of ordering commands like Prescribe and Lab Order, the order will not be sent until you commit the command. The only exception to the commit requirement is with the Reason for Visit which is always considered committed.

While commands share basic functionality, they are also unique. At the bottom of this article, the commands will be linked and any variant functionality will be shared.

User's Guide

Command Types

Commands organize structured data within a note. Each command is linked to a specific section of a traditional SOAP note and visually represented by a color-coded banner for easy identification.

Subjective	⚫ Black
Objective	🟢 Green
Assessment	🟠 Orange
Plan	🔵 Blue
Procedures	🟣 Purple
History	🟤 Brown
Internal	🔴 Red

Command Library

⚫ Subjective

Command	When to use
Reason for Visit (RFV)	Frames the motivation for the encounter. Chief complaint and reason for visit are used interchangeably.
History of Present Illness (HPI)	Captures the patient’s narrative about their current issue.
Review of Systems (ROS)	Screens for symptoms across body systems. ROS are considered micro-templates for specific findings and be customized for specific findings.
Questionnaire	Gathers structured patient input. Built using custom micro-templates. It is considered a micro-template that can be custom built to support a practice's needs.

🟢 Objective

Command	When to use
Vitals	Records vital signs during an encounter.
Physical Exam (exam)	Documents an examination that has been performed. It is considered a micro-template and can be custom built to document specific findings.
Visual Exam Finding	Uploads images to the patient chart. Requires the Canvas Remote app on iOS.

🟠 Assessment

Command	When to use
Assess Condition	Documents the assessment of an existing condition. Also accessible from the patient summary.
Diagnose	Adds a new diagnosis to the patient's chart.
Resolve Condition	Resolves an active condition currently listed in the patient's chart. Also accessible from the patient summary.
Change Diagnosis	Updates a diagnosis name/code without losing prior context such as the background or prior assessments.
POC Lab Test	To order, document, and charge for a test that has been completed within the office at the time of the visit
Lab Results Review	Allows providers to review and document new lab results. Includes communication to share with the patient and internal comments which will not be shared with the patient or posted on any external facing documentation.
Imaging Report Review	Allows providers to review and document imaging reports. Includes patient-facing communication and internal-only notes.
Consult Report Review	Used to document the review of a consult report. Providers can add internal comments and patient-directed messaging.
Uncategorized Document Report Review	Documents the review of an uncategorized document, internal comments, and document how a patient should be made aware of results.
Structured Assessment	Records the assessment of an existing condition. Considered a micro-template that is custom built to document specific aspects of an assessment.
Snooze Protocol	Delays a protocol for a specified period.

🔵 Plan

Command	When to use
Plan	Summarizes the visit plan.
Prescribe	Issues new prescriptions.
Refill	Issues a refill for an existing prescription.
Approve Refill	Approves and notifies the pharmacy of a refill.
Deny Refill	Denies a refill request and notifies the pharmacy.
Stop Medication	Ends a medication course or discontinues it.
Adjust Prescription	Updates an existing medication’s dosage or schedule.
Refer	Creates and sends a referral.
Lab Order	Orders lab tests electronically or via printed requisition.
Image	Orders imaging studies.
Instruct	Documents instructions given to the patient.
Educational Material	Provides patient education using Healthwise content.
Follow Up	Prepares and schedules a follow-up appointment for a patient.
Task	Assigns patient-linked tasks.
Goal Commands	Tracks and updates patient care goals.

🟣 Procedures

Command	When to use
Immunize	Records and bills for in office vaccine administration.
Perform	Records and bill for procedures completed in the office.

🟤 History

Command	When to use
Allergy	Records patient allergies.
Remove Allergy	Removes previously documented allergies.
Medication Statement	Documents historical medication use.
Immunization Statement	Adds historical immunization records.
Family History	Documents relevant family medical history.
Past Medical History	Adds past diagnoses or chronic conditions.
Past Surgical History	Records previous surgeries.

🔴 Internal

Command	When to use
Clipboard	Used to copy and paste free text into the note. Will not be shared on any external documentation.
Private Notes	Internal notes that can only be seen by the creator of the note. Will not be shared on any external documentation.
Create Coding Gap	Document a potential coding gap by suggesting a diagnosis that may be missing from the patient’s record
Validate Coding Gap	Confirm a suggested coding gap as clinically relevant and document its validity in the patient’s record.
Assess Coding Gap	Review a coding gap and either accept or refute it.
Defer Coding Gap	Temporarily postpone action on a coding gap when additional information or follow-up is needed before making a decision.

Command Function

Commands facilitate structured data entry in patient charts and are essential for efficient and accurate documentation.

Creating a Command

Within a note, type the name of the desired command into the note body.
Add each command on a new line.
Click or use keyboard navigation to select the appropriate command from the dropdown list.

Command Fields: consist of free text, structured and/or required fields.

Free text: Open entry without restrictions.
Structured fields: Dropdown menus for selection.
Required fields: Marked with red text and must be completed before committing the command.

Committing a Command

Click the colored button to the right of the command
- Click the colored button to the right of the command (e.g., Record, Sign, Designate).

Removing a Command

An uncommitted command can be removed from a note by clicking the X button to the right of the command
Once the command is committed, it cannot be reverted. If an error is made, the command will need to be entered in error.

Command Placement

Commands can be added directly to open notes or create new notes as necessary

Placing a Command in an Encounter Note

Place the cursor within an open note in the patient’s chart.
Use the relevant button in the Patient Summary or associated card in the Patient Panel to add the command.

Placing a Command into a Chart Review Note

Open the patient’s chart but do not click into a note.
Click an action button (stop, refill, review, etc) in the Patient Summary or Patient Panel to add a command. This creates a new Chart Review Note automatically.
Refresh the chart or manually create a new Chart Review Note if needed to ensure proper placement.

Commands initiated from the User Panel Filters in the Schedule View automatically create a locked Chart Review Note, eliminating the need to manually open the patient’s chart.

Moving Commands to New Note

The Move Commands feature allows uncommitted commands to be transferred from one note to another.

Open the note with the uncommitted commands that need to be moved.
Click the triple-dot menu in the note header and select Move Commands from the dropdown to open the modal.
Use the dropdown menu in the modal to choose the note where the commands will be moved.
Use the link in the confirmation message to verify that the commands have been successfully transferred

Only SDK enabled commands are able to be moved to a new notes. Reason for Visit will always remain in the original note.

Keyboard Navigation

Keyboard navigation increases user efficiency by allowing the completion of commands without the need of a mouse. While keyboard navigation is entirely optional, it does ensure streamlined, efficient charting and documentation in Canvas.

Navigation Basics

ENTER to select
TAB to navigate fields
ARROWS to move through dropdown menus

Navigating Fields

Free-text: Openly type in field
Dropdown menu: Use up/down arrows to navigate and ENTER to select.
Move fields: Press TAB to move to next field
Toggle/Radio Buttons: Press ENTER to switch on or off.

Committing Command

After completing fields, press TAB to highlight the commit button and press ENTER.
- If the commit button has a dropdown - press TAB again, navigate with ARROWS, and press ENTER on the selected option.

Highlighting Text

SHIFT + L/R arrows: One letter at a time
SHIFT + Up/Down arrows: One line at a time
SHIFT + CTRL (Windows) or OPTION (Mac) + L/R arrow: One word at a time

Triple Dot Menu

Every command holds a triple dot menu to the right of the command. This opens a list of options pertaining to the command. Standard items found:

Carry Forward: Pulls in the last recorded response. Disabled for commands intended to reference patient-specific data.
Audit History: Logs actions taken on the command with timestamps and user details.
- Uncommitted Commands: Version history is accessible for uncommitted commands through the audit history. Users can click Expand and Collapse to navigate through various versions.
  - To restore a previous version, click Revert to replace the current state with the selected version.
- Committed Commands: Version history becomes unavailable once a command is committed. The audit history will instead display a log of updates made before commitment.
Print: Allows command targeted printing or saving as a PDF.
Enter in Error: Marks committed commands as errors to remove from the patient record. It will be retained in the note with a strikethrough.
Create or Update Automation: Allows users to organize commands into reusable templates for efficiency and consistency. Review the Automations article for further details.

Configuration & Set Up

Managing Command Type Settings

Enabling or disabling specific commands ensures streamlined workflows and reduces clutter in patient charts:

To enable Command Type Settings, the practice must contact Canvas Customer Support to activate this permission.

Navigate to Settings > Practice: Command Type Settings to configure which commands are available for note documentation.
Search for commands needing modification using the search bar or filters.
Select the checkbox next to the command(s) needing modification
From the Action dropdown, select either Mark as active or Mark as inactive and click Go to apply the changes

This setting applies exclusively to commands manually entered in the chart note. Users can still add commands in other parts of the application, such as the Patient Panel or Summary section.

Automations are unaffected by disabling command types. If a command is needed in an automation but not independently, create the automation before disabling the command.

FAQs

Q: Can I delete a command after it has been committed?
A: No, once a command is committed it cannot be deleted. Instead, you can use the Enter in Error function to mark it appropriately.

Q: What happens if I forget to commit an ordering command?
A: The order will not be processed or sent until the command is committed.

Q: Can commands be moved after being committed?
A: No, only uncommitted commands can be moved between notes.

Q: Why can’t I find a specific command in my note?
A: Check if the command is marked as inactive in Command Type Settings.

Keywords & Metadata

Keywords: commands, documentation, charting, clinical workflows, committing commands, chart review notes, move commands, command types, editing commands. remove commands
Categories: Documentation, Clinical Workflows, Canvas Medical Guide