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Previous EMR had the feature that any EMR related action would be auto populated into the encounter note. This would act as the "PLAN" section of the SOAP note. Including
Medications Prescribed/renewed
Forms used
lab reqs
custom forms
notes given
etc
History Bans Updates
Allergies
History of problems
injections
family Hx
etc.
Vitals
Referrals mades
Hello
Just to clarify the request, in several EMR's, anything that happens on the same day of service is automatically added to the encounter. If an encounter note is viewed, printed or faxed, anyone can see what was done on that day, not just medical history. Yes, we are aware that this information is available in other areas of Accuro, but when a note is faxed, the recipient does not have access to this information. As well, in the previous EMR, if anyone looked at the encounter - at a glance they could see exactly what was done. the only way to do this now is to manually go in and an entry.
eg.
Ontario Lab Requisition printed
Low sodium diet handout printed
Flu shot
Referral Request
Hi Jason,
My apologies for any confusion; a number of submissions were merged together with the intention that the addition of a Refresh functionality would affect any inserted "tags" in a template. In the case of ACC-I-3020, the submitter is referencing "Medical History" as a whole, not "Medication History" specifically. All the same I have updated the wording of the original submission so that that is clear. Thank you for the offer to speak further on a phone call; when we are ready to explore either submission further I will absolutely reach out.
Hi Alison
This would be for more than just the medications. It would be for any update in the medical record that was related to the encounter note. Happy to discuss further on a phone conversation. Thank you,
Thank you for your feedback! There is a separate submission for adding a "Refresh" ability within Notes/Letters; you can vote/comment here: https://ideas.qhrtech.com/ideas/ACC-I-3020
I often complete requisitions, and updating the medication lists etc AFTER I have opened the encounter note. It would be ideal if one could refresh the encounter note afterwards to update the changes made.
E.g. I'm often editing the medication list because as pt's are talking to me they mention that they stopped a medication etc. I input this on the side panel but then have to manually update the encounter note.