In order that we satisfy the meaningful use requirement that we be able to exchange key clinical information, we should move to encoding the physical signs. This is a one time setup and easy to do. We are going to use LOINC values to encode the vital signs, as we already record laboratory results as LOINC. First off, we need to fix the Normal Ranges. Go to Settings/Normal Ranges, and click on SysBP. Change the Class from Name to LOINC, and change the Value from Systolic to 55284-4. Then click on the "Update" button. Do the same for DiasBP where the LOINC value is 8462-4, and BMI 41909-3. ( PS: if you don't see any Normal Range values you need to run the database update utility on your server ). Now you need to map any existing values. Find any patient who has any vitals recorded, and then in the Patients/Results/Numerical Results tab, click on any Vital sign which has not been coded ( LOINC will be none ), and then click on the "Map LOINC" button, select the appropriate vital sign from the table and then click on "Map". Henceforth, that vital sign when recorded will use that LOINC value.
Another advantage of doing this as it fixes up the graphs for Systolic and Diastolic BP. If you have ever done a Framingham CVS risk calculation, you will have entered Diastolic and Systolic risk values into the numerical tables. These are then mixed up with the systolic and diastolic pressure charts as the matching was done on the names. Switching to LOINC codes means that this no longer occurs.
