A work in progress - see mini video It will provide more space to each soap element, but there might be more clicking involved.
[quote user="Graham"] A work in progress - see mini video It will provide more space to each soap element, but there might be more clicking involved. [/quote] Will it still work like the current model, where once a consult note has been saved to soap format, only the subjective text appears in the full screen editor?
This is testing now. There is now only one edit tab .. no "SOAP mode" tab. just use the "2SOAP" button to toggle between the two modes. And templates now all insert into the open soap field.
Since I have now removed the newly redundant SOAP mode tab, looks like I have a spare tab to use. I could just use it for another historical encounter ...
Ok, I now have a different UI in mind. Instead of the SOAP concertina, I have a tree on the left which opens up on the right to the 15 or so different aspects of a consultation. Hmmm... perhaps instead of, in addition to .. so we would have 3 different ways of creating a consult. Admittedly this is to ensure that users can ensure that they can code to the highest level by making it easier to see what has been done.
I assume by the 15 or so aspects you're referring to PMH, PSH, SH, FH, etc... then they get all put together when saved like the SOAP template? That would make it easier to do more sophisticated templating for each aspect of a format consult (I think), and add the headers (PMH, PSH, etc.) just like the SOAP template. Maybe you could make it so that the user could make a default entry in each catagory of "Noncontributory" or something so that all catagories that the user chooses can be left "blank" if desired.
My intent would be to fill those sections automatically where possible and yes, have a button that says "non contributory", "no allergies know", "drugs reviewed" etc.
This is a very cool idea in that it serves the interests of the "lumpers" and the "splitters", i.e., now a user can have many more options to just do free-form notes or do a formal consult with more default text, headers and the ability to retrieve chunks of the consult in $variables.
It could look a little like this http://www.screencast.com/t/mRT0ciS27 though I personally wouldn't agree with the classifications.
If I have a complete accurate history, why would current medications, past history etc go into Subjective?
Who came up with the huge number of categories ? I thought the purpose of SOAP notes was simplifying things.
I've never really entertained a discussion about how exactly the "classical" medical consult format vs SOAP format developed. SOAP was the dogma in the 1970's that I "grew up" with for progress notes, but formal consults, either in hospital or outpatient from specialists, or formal H&P's were done "consult" style. I never saw much effort to unify the two approaches. So to me, the approach of "both and" is logical. SOAP is only very top level organization, and where to put the subcategories is very reminiscent of arguments between various Linux distros as to how files and folders should be organized. I think as long as you can use a top level folder, like just "Plan" if you choose, and ignore or add any particular subfolder, and be able to organize your templates in "Plan" the way you like, the New SOAP UI will be OK.
The categories you see here are based on what I've seen some other popular EMRs do. But it's about choice .. you will have three ways of documenting a progress note. The detailed one seems to be required to get the necessary level of coding for re-imbursement, but the flat style is what I will continue to use for consults.
Working model of the new physical examination editor. Click on an anatomical site, and appropriate adjectives appear. Probably have to create some defaults, and let the user edit them to make them more appropriate than those shown in the image above.
