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Having chosen the problem, it appears in the patient's problem list.

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The figure below shows the Problem List pane:

Total of 2,613 concepts consisting of the top 2,500 most frequently used problem list concepts used by Kaiser Permanente plus a few related concepts.

When you are writing up your note, the template can have a specialized problem list, appropriate to the type of note. When you click one of these, the problem goes into the patient's problem list, just as above.

The critical issues with problem lists are:

  1. Once an accurate diagnosis has been established in the Chronic Problem List. a robust ICD-9 code list and certainly an ICD-10 code list with 150,000 options, can require unnecessary review to make sure that the diagnosis in the Acute Assessment correlates with the diagnosis in the Chronic Problem List.  Therefore. must be a means for moving diagnoses from the Chronic Problem List to the Acute Assessment for the current encounter.
  2. SETMA accomplished this by placing buttons next to each space of the acute assessment. When the button is deployed, the Chronic Problem List appears in a new window.  When the Chronic Problem being evaluated is highlighted by the provider, a copy of it is moved to the Acute Problem. This allows for consistency in what is being evaluated thus preventing the duplication of diagnoses, or the changing of a precise diagnoses to a more generic one. 
  3. As we migrate to ICD-10 in 2014, accessing Acute Assessment diagnoses will be more complicated when you are drawing from a 150,000 element list.  Being able to move an establish Chronic Problem from the Chronic Problem List to the Acute Assessment will make sure that you don’t have multiple codes with slightly different meaning for the same condition. 

Problem List reconciliation is a team effort including the following:

Paul Watzlawick - Wenn die Loesung das Problem ist (1987) Philosophie Psychologie

Anleitung zum Unglücklichsein
radikaler Konstruktivismus

Objective: Maintain an up-to-date problem list of current and active diagnoses.
Measure: More than 80 percent of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data.
Exclusion: No exclusion.
Full Details: