Patient Encounter: Problem List

OP sets all defaults to share all information. Any individual decisions by Practice-users to restrict information sharing (access, use, or exchange) are the responsibility of the Practice in the implementation of its 21st Century Cures Act Information Blocking policies and procedures for its Practice and patients.

Version 20.18

This window map article points out some of the important aspects of the window you're working with in OP but is not intended to be instructional. To learn about topics related to using this window, see the Related Articles section at the bottom of this page.

About Patient Encounter: Problem List

Path: Clinical, Practice Management, or Billing tab > Patient Chart button > Encounter > New or Open Note button > Problem List

The Problem List section of the Encounter Note displays and documents all patient Diagnoses and Problems for the patient’s past medical history, allows for Tracking specific Diagnoses or Problems for reporting purposes, shows scanned items, and adds/edits chart note worksheets. This section of the Encounter Note is chart-driven, meaning that the information populated here is pulled from and pushed back to the same section in the Patient Chart.

Patient Encounter: Problem List Map

Number
SectionDescription

1

Problem List buttonThe Problem List button accesses the Problem List window in the patient's Encounter Note.
2
Encounter Function buttons
The Function buttons delete an entire Encounter Note, edit an Encounter Note, or save an Encounter Note.
3
List tabs
  • Problem List: The Problem List tab contains a complete list of problems for a patient's present and past medical history.
  • Scanned Records: The Scanned records tab displays a patient's scanned item with the label "Chart" as the item type in its document properties. This tab sorts images by date, category staff, etc. It also can change the recipient directly from the scan window. This tab does not include items linked directly to notes on the Problem List tab.
4
Problem List Function buttons
The Problem List functions buttons are:
  • New: Opens the Problem List window to add a problem to the Problem List.
  • Edit:  Opens the Problem list window to alter the selected problem in the Problem List.
  • Delete: Deletes a problem from the Problem List.
  • Mark Reviewed: Marks a selected problem in the Problem List as reviewed. The reviewed indication is time stamped.
  • Print: Prints the patient's Problem List.
  • No Problems: Provides an indicator that there are no active problems for the patient.
  • Refresh: Allows users to refresh the screen after entering their Emergency Override credentials.
5
Flag as Incomplete checkboxThe Flag as Incomplete checkbox marks an Encounter as unfinished.
6
Prioritize buttons

The Prioritize buttons move a problem up and down in the Problem List.

7
Problems ListThe Problems List is a list of all the patient's medical conditions (past and present). The list indicates the problem, status, onset date, resolved indication, updated, and privacy level. Clicking on the Paperclip button will add the selected problem to the PMFS History text box as well as add a sentence that the Problem List was reviewed with a date and time stamp.
8
PMFS History/Meds ReviewedThe PMFS History/Meds Reviewed field is a text box where you can enter or review a patient's past or current problems. You can also indicate that the patient does not have any problems in this field. Current medical problems can also be listed in this field.
9
Auto-copy problems to encounter diagnosis list checkbox
The Auto-copy problems to encounter diagnosis list checkbox adds the selected problem to the diagnosis or assessment of the note.
Version 20.17

About Patient Encounter: Problem List

Path: Clinical, Practice Management, or Billing tab > Patient Chart button > Encounter > New or Open Note button > Problem List

The Problem List section of the Encounter Note displays and documents all patient Diagnoses and Problems for the patient’s past medical history, allows for Tracking specific Diagnoses or Problems for reporting purposes, shows scanned items, and adds/edits chart note worksheets. This section of the Encounter Note is chart-driven, meaning that the information populated here is pulled from and pushed back to the same section in the Patient Chart.

Patient Encounter: Problem List Map

Number
SectionDescription

1

Problem List buttonThe Problem List button accesses the Problem List window in the patient's Encounter Note.
2
List tabs
  • Problem List: The Problem List tab contains a complete list of problems for a patient's present and past medical history.
  • Scanned Records: The Scanned records tab displays a patient's scanned item with the label "Chart" as the item type in its document properties. This tab sorts images by date, category staff, etc. It also can change the recipient directly from the scan window. This tab does not include items link directly to notes on the Problem List tab.
3
Encounter Function buttonsThe Function buttons delete an entire Encounter Note, edit an Encounter Note, or save an Encounter Note.
4
Flag as Incomplete checkboxThe Flag as Incomplete checkbox marks an Encounter as unfinished.
5
Problem List Function buttonsThe Problem List functions buttons are:
  • New: Opens the Problem List window to add a problem to the Problem List.
  • Edit:  Opens the Problem list window to alter the selected problem in the Problem List.
  • Delete: Deletes a problem from the Problem List.
  • Mark Reviewed: Marks a selected problem in the Problem List as reviewed. The reviewed indication is time stamped.
  • Print: Prints the patient's Problem List.
  • No Problems: Provides an indicator that there are no active problems for the patient.
6
Prioritize buttons

The Prioritize buttons move a problem up and down in the Problem List.

7
Problems ListThe Problems List is a list of all the patient's medical conditions (past and present). The list indicates the problem, status, onset date, resolved indication, updated, and privacy level. Clicking on the Paperclip button will add the selected problem to the PMFS History text box as well as add a sentence that the Problem List was reviewed with a date and time stamp.
8
PMFS History/Meds ReviewedThe PMFS History/Meds Reviewed field is a text box where you can enter or review a patient's past or current problems. You can also indicate that the patient does not have any problems in this field. Current medical problems can also be listed in this field.
9
Auto-copy problems to encounter diagnosis list checkbox
The Auto-copy problems to encounter diagnosis list checkbox adds the selected problem to the diagnosis or assessment of the note.