NHIS (HIS BG)
This page is for medical practices that submit electronic examinations to NHIS. Use it to prepare the data of the healthcare facility and the specialist, to close an examination with the patient's signature, and to find an examination that is already submitted.
When to use this page
- When you set up NHIS for the first time and have to fill in the data of the location and the specialists.
- When you open, close or void an examination in NHIS.
- When you want the patient to sign the outpatient sheet on a tablet instead of on paper.
- When you have to check whether an examination for a given patient is already submitted.
Before you start
- The account must have the NHIS part switched on. Without it, the NHIS fields and buttons are not shown anywhere.
- In Locations, fill in "Medical facility registration number according to the HIS register" for every location.
- In Employees, fill in "UIN of the medical specialist" and "Specialty code" for every medical specialist.
- Work through the desktop application. The exchange with NHIS goes through signing with a qualified electronic signature, which needs a computer with access to your certificate.
If the UIN, the specialty or the registration number of the healthcare facility is missing, the examination cannot be sent to NHIS.
Where to find it
- Top menu in the computer version: "Integrations" → "HIS". It holds "Search examinations" and "Patient signature device".
- From the client row in the appointment: the "E-Examination" button. It is shown only for an existing client, not for a new one.
When you pick a specialist and a location in the examination, the system takes the UIN, the specialty and the registration number from their own settings. If the role requires a deputy specialist, a field for choosing a deputy appears as well.
How the examination screen is arranged
The examination opens as "E-Examination" and follows the order of the actual work:
- "Patient information"
- "Examination and specialist"
- "Medical history"
- "Objective condition"
- "Primary diagnosis"
- "Assessments"
- "Therapy"
At the top sits the bar with the state of the examination in NHIS: the NRN with a copy button, the current status and the available actions. While the examination is not submitted yet, it reads "The examination has not been opened in HIS yet."
Once the examination is open, the patient data block collapses to a single line. You open it again with the button that shows the details. The optional address fields stay hidden and appear on their own when data is already there.
In the text fields for medical history, objective condition, diagnosis, assessments and therapy you can pick a value from an earlier examination. Next to the field there is a button with the tooltip "Click to see list with last used values".
The suggestions come from the last examinations of the specialist selected in "Examination and specialist". If you change the specialist, the list refreshes. While no specialist is selected, the button is not shown.
"Assessments" is free text of up to 4000 characters, like the other notes. The text is submitted to NHIS together with the examination and printed on the outpatient sheet between "Objective condition" and "Therapy".
The field for each note on the outpatient sheet fits about four lines. Longer text is shortened on the sheet with an ellipsis, while the full text stays recorded in the examination and in NHIS.
Steps: from a new examination to closing it
- Open "E-Examination" from the client row in the appointment.
- Fill in the data. For a new examination, part of the patient data is filled in from the last examination of the same client.
- Press "Save" to record the examination on your side without submitting it to NHIS.
- Press "Save and open in HIS" to submit it. After a successful submission you see the NRN and the status.
- When the examination is ready, press "Close in HIS".
The buttons at the bottom change with the state of the examination:
| State of the examination | Available buttons |
|---|---|
| Not recorded yet | "Save", "Save and open in HIS" |
| Recorded but not submitted | "Save", "Download outpatient sheet", "Save and open in HIS" |
| Open in NHIS | "Save", "Close in HIS" |
| Closed or voided | "Download outpatient sheet" |
Until the examination is closed or voided, a delete button sits next to them.
The outpatient sheet does not have to go through NHIS. If you work on paper, you record the examination, download the sheet and the patient signs it — that path is equally valid.
A closed or voided examination can be neither edited nor deleted. The screen reads "The examination is closed and can no longer be edited.", the fields are locked, and the delete button is not shown. NHIS holds the accepted document, and a local change would only make the two records drift apart.
What is required when closing
Before "Close in HIS" you must have filled in:
- "Medical history" and "Objective condition";
- a diagnosis, and with it "Clinical status", "Verification status" and "First manifestation of symptoms".
Those three fields on the diagnosis are an NHIS requirement. If they are missing, closing stops before the signing step — not after it.
The messages you may see:
- "No diagnosis entered";
- "Clinical status, verification status or symptom onset of the diagnosis are missing".
Patient signature on a tablet
The patient can sign the outpatient sheet on a connected signature tablet instead of on paper. The signature is captured at the moment the examination is closed and appears on the printed outpatient sheet, in the patient column.
What you need
- A Windows computer with the desktop application.
- A signature tablet connected over USB. The feature is verified on a Wacom STU-430.
- The Wacom software installed on the same computer — the tablet driver and SigCaptX.
- A device selected on this computer.
Install the Wacom software
Download the software from the official Wacom site and install it on the computer where signing will take place. Without SigCaptX the application does not offer signing on a tablet — the signature lines in the examination are not shown at all.
- The tablet driver. Open the Wacom drivers page, select the "Signature Pads" category and your model, STU-430 for example.
- Wacom Ink SDK for signature. Install it before SigCaptX — SigCaptX runs on top of it.
- SigCaptX. Install it last. It is the link between the application in the browser and the tablet.
- Restart the computer, connect the tablet over USB and open the desktop application.
Wacom Ink SDK for signature and SigCaptX are downloaded from the Wacom developer site — developer.wacom.com. A Wacom account is required for the download.
The installation is done on every computer where signing will take place. No signature licence is entered anywhere — it comes with the application.
Select the device
- Open "Integrations" → "HIS" → "Patient signature device".
- Select "Manufacturer" and "Model".
- Press "Save".
After that the menu shows the model you selected next to the name.
The device is stored on this computer only. If you have several rooms with tablets, select the device on each computer separately. The screen itself says the same: "The device is saved on this computer only. Select it again on every computer with a signature pad."
What you see in the examination
When the examination is open, one of two lines appears in the bar at the top:
- "When you close the examination, the patient will sign it on the connected tablet." — everything is ready. Next to the text there is a "Change device" link.
- "A signature pad is connected, but no device is selected on this computer." — the Wacom software is ready, but you have not selected a model yet. Next to the text there is a "Select device" link.
If SigCaptX is not installed or not running on this computer, these lines are not shown and the examination is closed as before.
When someone else signs
When the person signing is not the patient, switch on "The signer is different from the patient (parent/guardian)". Fields "Identifier type", "Identifier", "Name" and "Lastname" open for the person who signs.
If the signature does not go through
The signature never stops the examination from being closed. If the patient declines or the tablet does not respond, you see a message with two choices:
| What you see | Most common cause | What to do |
|---|---|---|
| "The patient declined to sign" | The patient pressed cancel on the tablet itself | "Try again" or "Close without signature" |
| "The signature pad is not responding" | The cable is unplugged or the tablet is not ready | Check the cable, then "Try again" or "Close without signature" |
With "Close without signature" the examination is closed normally and the patient signs the printed outpatient sheet, as before.
Searching for an already submitted examination
Open "Integrations" → "HIS" → "Search examinations".
"Searching as" is required — this is the specialist on whose behalf you ask NHIS.
After that you have two paths:
- By NRN. Fill in "NRN". This is the targeted search — when an NRN is present, the other fields are not used.
- By patient data. Fill in whatever you have of "Identifier type", "Identifier", "Name", "Lastname" and "Date". You do not have to fill in all of them.
Two rules for the second path:
- If you fill in an identifier, select its type as well. Otherwise you get "Select the identifier type as well."
- The name is searched as a pair. If you fill in only one of the two, you get "Enter both the name and the lastname."
The identifier can contain letters too, so a passport number or a personal foreigner number works.
The date is not prefilled. Leave it empty when you look for an older examination — a filled date narrows the results down to that day only.
What the results show
Above the list you see "Found" and the number. For every result you see the NRN with a copy button, the patient's names, the identifier, the date and time, the UIN of the specialist and the current status in NHIS.
If there is no match, you get "No examinations match the search criteria."
Open the whole examination
The "Open" button next to a result shows the examination exactly as NHIS returns it — "Examination in HIS". This is a read-only view with the full content of the examination: patient data, examination information, diagnoses and comorbidities, medical history, objective condition with findings and diagnostic reports, therapy, consultations, sick leaves and issued documents.
The volume differs by specialty — what is shown is what NHIS actually returned for that examination.
Actions on an already submitted examination
- "Void" voids an open examination and asks for a reason. The reason then stays visible in the examination.
- "Download outpatient sheet" downloads a PDF of the outpatient sheet. When the patient signed on a tablet, the signature is on the sheet.
Common problems
- The examination cannot be sent. Check the UIN and the specialty code of the employee, and the registration number of the healthcare facility in the location.
- NHIS refuses when closing. The message from NHIS is shown on the screen. Most often one of the required fields on the diagnosis is missing.
- The tablet is not detected. Check that you work through the desktop application on Windows, that the Wacom driver and SigCaptX are installed on this computer, that the tablet is connected, and that you have selected a device. If you have just installed the Wacom software, restart the computer.
Limitations
- "E-Examination" opens only for an existing client in the appointment.
- "E-Dental treatment" is visible in the interface but does not work.
- There is no separate screen for managing the NHIS access — the system requests new access at the moment it is needed.