OctalCare
User Guide

What OctalCare does

OctalCare replaces the paper registers, receipt books and spreadsheets of the health center with one system. Every service follows the patient: reception, cash desk, consultation, laboratory, pharmacy and reports all share the same record.

You only see the menus your job needs. A cashier does not see clinical notes, and a doctor cannot change a bill. If a menu in this guide is missing for you, your account doesn't have that job. Ask your administrator.

Find your job

Choose your job to go to the chapter written for you. Everyone should also read Signing in and the golden rules.

The 6 golden rules

OctalCare works like a bank ledger. Knowing these rules explains almost every message the system will show you.

Signing in

Use the web browser on your work computer (Chrome, Edge or Firefox). Your administrator gives you the address of OctalCare, your email address and a first password.

1. Open the OctalCare address in your browser.
2. Type your Email address and your Password.
3. Click Sign In.
4. If you have two-step verification, type the 6-digit code from your phone (see below).
5. The first time you sign in with a password you were given, change it from My Profile → Security Settings.

To sign out, click your name at the top right, then Sign Out. Always sign out on a shared computer.

Two-step verification (2FA)

Two-step verification means that signing in needs your password and a code that changes every 30 seconds on your phone. A stolen password alone is then useless.

It is required for administrators, auditors, Billing Supervisors, Management and HR Managers. If your job is one of these, OctalCare sends you to the setup page as soon as you sign in and you can't continue until it is done. Anyone else may switch it on too.

1. Install a free authenticator app on your phone: Google Authenticator or Microsoft Authenticator.
2. In OctalCare, open My Profile → Security Settings and choose to set up two-step verification. (If it is required, you are taken there automatically.)
3. In the app, tap + and scan the square code shown on the screen.
4. Type the 6-digit code the app shows and confirm.
5. From now on, after your password, OctalCare asks for the current code from the app.

Forgotten password

1. On the sign-in page click Forgot password?.
2. Type your email address. You receive a link by email.
3. Open the link and choose a new password. Use at least 8 characters, mixing letters and numbers, and don't reuse an old one.

No email? Your administrator can also reset your password from Staff Accounts.

Finding your way around

Every page has the same three parts.

Colours you will see on screen

Paid Issued Validated mean done and safe. Deferred Draft Doctor on leave mean attention needed. Critical Overdue mean act now. Cancelled Void mean no longer in use.

Your profile & language

Click your name at the top right, then My Profile. There you can:

• check your name, phone and email (Personal Information);
• change your password and set up two-step verification (Security Settings);
• choose your language: English or Français.

A patient's visit, start to finish

This is the path every patient follows. Each team does its part and the system passes the patient on to the next one. The orange steps are payments at the cash desk.

Reception & front desk

Find or register a patient

Always search before registering. A patient registered twice ends up with two medical histories.

1. Open Patients → All Patients.
2. Search by name, phone number or patient number.
3. If the patient exists, click their name to open the record.
4. If not, click Patients → Add Patient.
5. Fill in at least first name, last name, date of birth, sex and a phone number. Also add the address and an emergency contact if possible, and choose the usual doctor (Primary clinician) if the patient has one.
6. Save. OctalCare gives the patient a unique patient number. Write it on their card.

To correct a patient's details later, open the record and click Edit. The old values are kept in the history.

Book an appointment

1. Open Appointments → Book Appointment, or click Book appointment on the front desk.
2. 1 · Patient: search and choose the patient.
3. 2 · Doctor & time: choose the doctor and the day. OctalCare only shows free times, based on the doctor's hours and leave.
4. Click a free time, then Book.

All bookings are in Appointments → Appointments. From there you can Move a booking to another time, Cancel it, or mark a patient who didn't come as No-show.

Check a patient in

Do this when the patient arrives, with or without an appointment.

1. Open Appointments → Front Desk / Check-in. The page shows today's appointments, the doctors working today and who is on duty now.
2. Patient with an appointment: click Check in on their line in Today's appointments.
   Walk-in patient: use Check in a patient. Choose the patient (or click New patient), the doctor and the type of consultation.
3. Tick urgent if the patient needs to be seen first.
4. Confirm. A consultation invoice is created automatically.
5. Send the patient to the cash desk. Once they have paid, they appear in the doctor's queue by themselves.

Cashier & billing

Everything starts from Billing → Cashier Desk. It lists what is waiting to be paid: Invoices not yet paid, Lab orders awaiting payment and Prescriptions awaiting payment.

Take a payment

1. On the Cashier Desk, find the patient in one of the lists, or type their name in Find patient.
2. For a consultation, the invoice already exists: click Take payment.
   For lab tests or a prescription, click Bill first to create the invoice, then take the payment.
3. Check the lines and the total with the patient.
4. Choose how they pay: Cash, Mobile Money or Bank transfer / cheque. For Mobile Money or bank, type the transaction reference.
5. Type the amount received. A patient may pay part now and the rest later; the invoice then shows Partly paid.
6. Click Record payment & issue receipt.

Print a receipt

On the invoice, after payment, choose the printer:

The receipt prints in your language (see Your profile). You can reprint a receipt at any time from the invoice.

Emergencies, debts & voids

Emergency: release without payment (deferral)

For a patient who must be treated before paying (emergency, unconscious patient…):

1. The director opens the invoice (Billing → Cashier Desk, find the patient). In Emergency — release without payment, they write the reason.
2. They click Defer payment and confirm.
3. The services are released at once. The amount stays on the patient's balance as a debt: Deferred.

When the patient comes back to pay, open the invoice and take the payment normally. All debts are listed in Billing → Deferred / Debts.

Void an invoice

An invoice created by mistake that has not been paid can be voided by the director: they open it, click Void and give the reason. A cashier who billed something by mistake asks the director to void it. It stays in the system marked Void. A paid invoice cannot be voided. When a receptionist cancels a visit before it is paid, its consultation invoice is voided automatically.

Daily collections & price list

• Billing → Daily Collections: all payments of the day by cashier and by method. Use it to count your cash drawer at the end of the shift.
• Billing → Price List: the prices of consultations, lab tests and medicines in FCFA. Billing Supervisors can change them; changes apply only to new invoices and are recorded.

Doctors & clinicians

Your queue

Open Appointments → My Queue. It has three parts:

• Waiting (paid): patients ready for you, urgent ones first, then in order of arrival.
• Checked in, not yet paid: patients still at the cash desk. You can't start them yet.
• Seen today: consultations you have finished.

1. Click Call & start on the next patient. The consultation starts and the waiting time is recorded.
2. Click Open record to see the patient's file.
3. When you are done, click Complete consultation, either in the queue or on the patient's record.

During a consultation

The patient record shows the latest vital signs at the top, then Clinical Notes, Lab Orders and Recent Prescriptions.

Write a clinical note

1. In New Clinical Note, choose the type of note and write the chief complaint.
2. Enter the vital signs: heart rate, SpO₂, blood pressure, temperature.
3. Write your examination and plan in the main text box.
4. Choose the Primary diagnosis (ICD-10) from the list. Start typing, e.g. "paludisme" or "B54".
5. Click Save Note.

Order a lab test

1. On the patient record click Order Lab Test.
2. Choose the tests from the catalogue (e.g. "TDR", "NFS", "Glycémie").
3. Choose the priority (routine or urgent) and add a note for the lab if needed.
4. Save. Send the patient to the cash desk. The lab receives the order once it is paid.

Results appear in Lab Orders on the patient record once the lab has entered them. Critical results also trigger an alert.

Write a prescription

1. On the patient record click New Prescription.
2. Add each medicine: product, dosage (e.g. "1 tab 3×/day"), quantity and duration.
3. Click Save Draft. A draft can still be changed.
4. Check it, then click Issue Prescription. This is your electronic signature; the prescription gets a number and can no longer be changed.
5. Send the patient to the cash desk, then to the pharmacy.

Print a medical report

To give a patient a written report (referral, insurance, travel…):

1. On the patient record click Medical report.
2. Choose One consultation to report a single visit, or Medical summary for a period of dates or the whole history.
3. OctalCare produces a PDF on the health center's letterhead, signed with your name. Print it or save it.

Every printed report is recorded with your name.

Case investigation form (FII)

For a notifiable disease (e.g. suspected measles, cholera, meningitis), click FII on the patient record and choose the date. A MINSANTE Fiche Individuelle d'Investigation opens, already filled from the record where possible. It never shows the patient's name. Complete it and give it to the person who validates MINSANTE reports.

Break-glass access (emergency access)

If you need the record of a patient who is not yours today (e.g. an emergency at night), OctalCare asks you why.

1. Open the patient. The Break-Glass Access page appears.
2. Write the clinical justification: who, why, what is urgent.
3. Confirm. You have access for about one hour.

Your profile page

Doctors → My Profile shows your schedule, today's patients and your statistics.

Laboratory

Open Laboratory → Orders Queue. It lists the orders that are paid (or deferred), with urgent orders marked. Unpaid orders don't appear: send the patient to the cash desk.

Enter results

1. Collect the sample and click the order number.
2. For each test, type the result in each line. A blood count (NFS) has one line per value; a culture has a text report.
3. Click Save Results.
4. OctalCare compares numbers with the reference range and marks them High, Low or Critical. Tests without a range show Not flagged.

Critical results

A result in the dangerous range creates an alert in Laboratory → Critical Alerts.

1. Call or tell the requesting doctor straight away.
2. Click Acknowledge to record that the alert has been handled.

Verify & print

Results reach the doctor as final only once they are verified.

1. A second qualified person opens the order and checks the results.
2. They click Verify Order. After that, results can no longer be changed.
3. Click Download PDF to print the result sheet on the letterhead.

Test catalogue

Laboratory → Test Catalogue holds the test list (the Centre Pasteur 2020 catalogue is loaded). The Lab Manager can:

• set units, reference ranges and critical values for each result line, so that flagging works;
• add a new test, or deactivate one that is no longer done. Tests are never deleted.

Every change is recorded. Test prices are set separately, in Billing → Price List.

Pharmacy & dispensing

You see issued prescriptions. A prescription can be dispensed only for the quantity that has been paid.

1. Ask the patient for their receipt or name and open the prescription (search by number or patient).
2. Click Dispense.
3. Choose the location you are taking the stock from (e.g. the dispensary shelf).
4. Check the quantity for each medicine. You can give less if you are short; the rest stays to be dispensed later.
5. Confirm. OctalCare automatically takes the batch that expires first (FEFO). Quarantined, recalled and expired batches are never used.

The prescription now shows Dispensed and Remaining for each line, and a Dispense History with the batches given. If a batch is recalled later, the system can find every patient who received it.

Stock & inventory

The menu Inventory manages medicines, reagents and supplies. Stock quantities are never typed in; they are calculated from every receipt, transfer and dispense.

Products & stock levels

• Inventory → Overview: low stock, items about to expire, alerts.
• Inventory → Products: every product with its generic (INN) name, brand, form, strength, storage (ambient, fridge, frozen, controlled) and substitutes. Use Add Product for a new one.
• Inventory → Stock Levels: how much of each product is at each location, batch by batch, with expiry dates.
• Inventory → Locations and Categories: the stores, shelves and product groups.

Ordering & receiving

1. Inventory → Reorder Suggestions lists what is below its minimum level. Minimum and maximum levels are set in Reorder Rules.
2. Open Purchase Orders and click Create Purchase Order. Choose the supplier (from Suppliers) and add the lines.
3. When the delivery arrives, open the order and choose Receive. For each line, type the batch number, the expiry date, the quantity received and the cost.
4. Click Confirm Receipt. Stock goes up at once. If quantities don't match the order, the receipt is marked with a discrepancy.

Damaged or wrong goods go back through Supplier Returns (Process Return).

Moving stock

• Inventory → Movements → Record Movement: transfer from the main store to the dispensary, requisitions, adjustments and write-offs (expired, broken). Every movement has a "from" and a "to", and write-offs need a reason.
• Ward Returns: medicines brought back unused by a ward or a patient.
• Quarantine: on a batch, choose quarantine and give the reason. The batch can't be dispensed until it is released.

Stock counts (inventaire)

1. Open Cycle Counts and create a count for a location.
2. When counting starts, the location is frozen: no movement can happen there until the count ends.
3. Type the quantities you physically count and click Save Counts.
4. A manager approves the count. Differences are posted as adjustments and the location is unfrozen.

Recalls, cold chain & controlled drugs

• Recalls → Initiate Recall: when a manufacturer or the authorities recall a batch. The batch is quarantined everywhere and the recall page lists every patient who received it.
• Fridge Temp Logs → Save Reading: record the vaccine fridge temperature, morning and evening.
• Cold Chain → Log Breach: when a fridge went out of range. The affected batches are quarantined until someone decides (Resolve).
• Controlled Register: the register of all movements of controlled (narcotic, psychotropic) products. Only authorised staff can see it.
• Serial Numbers: for expensive items tracked one by one.

Stock reports & SYNAME

Inventory → Reports gives four reports:

• Stock Valuation: how much the stock is worth;
• Consumption History: what was dispensed over a period;
• Dead Stock: products that haven't moved in 30, 60, 90 or 180 days;
• Shrinkage & Loss: all write-offs and adjustments.

The monthly SYNAME report for the national drug system is in Reports → SYNAME: choose the month, click Generate, then download the PDF.

Doctors, schedules & roster

Add a doctor

1. Open Doctors → Add Doctor.
2. Fill in name, email, phone, specialty, ONMC licence number, year they started practising and, if you like, a photo and a short biography.
3. Save. OctalCare creates the doctor's login and shows a one-time password once. Write it down and give it to the doctor privately. They must change it at first sign-in.

Doctors → All Doctors shows every doctor with their status: Active, On leave (leave recorded for today) or Inactive. To edit a doctor, open them and click Edit. When a doctor leaves the center, change their status to inactive and write the reason. Their login stops working, but their records stay.

Working hours and leave

1. Open Doctors → Doctor Schedules and choose the doctor.
2. Add hours: the days and times they consult, e.g. Monday 08:00–13:00. Patients can only be booked inside these hours.
3. Add time off: holidays, training, sick leave. Those days disappear from booking. Bookings already made are marked Doctor on leave for reception to move.

Staff roster (duty rota)

Appointments → Staff Roster shows who works each shift of the week. Everyone can see it; the Roster Manager fills it in and clicks Save week. Night shifts that cross midnight are handled. The front desk shows On duty now from this roster.

Dashboard & analytics

The dashboard

The Dashboard (first item in the menu) adapts to your job. A doctor sees My day; reception sees Patient flow; a cashier sees My cash desk; management sees Money, Laboratory, Pharmacy & stock and Security, with charts of the last 14 days. Figures are always live and calculated from the records.

Analytics reports

Open Reports → Analytics and choose a report:

1. Choose the dates and click Show.
2. Click PDF for a printable copy on the letterhead, or CSV to open the figures in Excel.

MINSANTE reports

Open Reports → MINSANTE reports. OctalCare prepares the official reports for the district, with the figures it can find already filled in.

Prepare a report

1. Click the report, choose the period (week, month, quarter or year) and click Prepare report. If a report already exists for that period, it opens instead.
2. Look at the cells:
   • Filled cells come from OctalCare's records (consultations, diagnoses, lab tests, medicines, stock, money).
   • Empty white cells must be typed from the paper registers (vaccinations, deliveries, community work, expenses…).
   • Totals and rates are calculated by themselves.
3. Type the missing values and click Save regularly.
4. If records changed since you started (late notes, new results), click Save & recalculate figures. Your typed values are kept.
5. Print the draft with PDF (draft) to check it. Drafts carry the word BROUILLON across the page.

Validate and send

1. A member of Management opens the draft, checks it and clicks Validate.
2. The report is now Validated and frozen: nobody can change it. The PDF shows who validated it and when.
3. Print the PDF on the letterhead, sign and stamp it, and send it to the district.

Administration & security

Staff accounts

Staff Accounts (administrators only) lists every login.

• Create an account for each new staff member. One person, one account; never share logins.
• Give each account a role (Clinician, Admin staff, Auditor…) and the groups that match the job, for example Cashier, Lab Technician, Pharmacist or Store Clerk. The groups decide which menus the person sees.
• Reset a password or two-step verification when someone is locked out or loses their phone.
• When someone leaves, deactivate the account the same day. Accounts are never deleted, so their history stays.

Roles & Permissions shows what each group can do. Change it only if you understand the effect; every change is recorded.

Branches & letterhead

Branches holds the health center's details: name, health district, region and the letterhead. Upload the letterhead as an A4 image. Every PDF the system prints (lab results, receipts, medical reports, MINSANTE reports…) uses it. If text overlaps the printed header or footer, adjust the top and bottom margins on the same page.

Security reviews

• Patients → Break-glass Review: every emergency access to a record. Read the justification, check it with the doctor if needed, then click Mark Reviewed, within 24 hours. A line marked "Not alerted" means the warning email failed: tell the patient's doctor yourself.
• Audit log: OctalCare keeps a sealed log of every action. Each line is chained to the one before, so any change or deletion is detected. It is checked automatically every night and the administrator is warned if anything is wrong. Nobody can modify it, not even the administrator.

Problems & answers

Words explained

Audit log

The sealed record of every action in the system: who, what, when and from where.

Batch

A lot of a product with one batch number and one expiry date.

Break-glass

Emergency access to a record of a patient who is not yours, with a written reason that is reviewed.

Check-in

Recording the patient's arrival for a doctor today. It creates the visit and the consultation invoice.

Critical result

A lab value so far outside the normal range that the doctor must be told straight away.

Cycle count

A physical stock count (inventaire) of one location.

Deferral

Releasing a service before payment (emergency). The amount stays owed by the patient.

Draft

Work that is saved but not final, so it can still be changed: a prescription not issued, a report not validated.

FEFO

"First expired, first out": the batch that expires first is used first.

FII

Fiche Individuelle d'Investigation: MINSANTE form for each case of a notifiable disease.

Four-eyes rule

Two different people are needed: one enters lab results, another verifies them.

ICD-10

The international list of disease codes (e.g. B54 = malaria) used for diagnoses and statistics.

Issue

Making a prescription final; it then counts as the doctor's signature.

Letterhead

The health center's official header and footer, printed on every PDF.

MINSANTE

Ministère de la Santé Publique, Cameroon's ministry of public health, which receives the official reports.

Quarantine

Blocking a batch so it can't be dispensed until someone checks it.

SYNAME

Système National d'Approvisionnement en Médicaments: the national drug supply system and its monthly report.

Two-step verification (2FA)

Signing in with your password plus a 6-digit code from your phone.

Validate

Approving a MINSANTE report so it is frozen and ready to send.

Void

Cancelling an unpaid invoice created by mistake. It stays visible, marked "Void".