Brief Overview
Our Diagnoses option is available within the clinical consult for users with Doctor access. This integration with Snomed Clinical Terms (CT) allows you to search for the most comprehensive, multilingual healthcare terminology in the world.
Note: There is currently no reporting for the Diagnoses field.
The Short Version
- Double click a patient appointment to open a clinical consult or use the Quick Consult icon.
- Select the Plus option on the Diagnoses field.
- Search the Diagnosis, add the Status, When Diagnosed and any Clinical Notes.
- Click Add.
- Make a diagnosis Inactive or Delete (as required).
Instructions
1. Open a consult by double-clicking on a patient's appointment in the Scheduler. If you would like to add a note to a patient who does not have an appointment, use the Quick Consult.
2. Select the Plus icon on the Diagnoses field.
3. Complete all fields:
- Search the Diagnosis using Snomed CT
- Choose if the diagnosis is Active or Inactive
- Select When Diagnosed
- Add any Clinical Notes
- Toggle if this was Reported by the Patient
4. Click Add.
5. The details will be added to a list for this patient. If the diagnosis is highlighted blue, click on the name to see the clinical notes added.
If there are two of the same diagnosis for the patient, this will show with a drop-down arrow. Click on this to show the details of the multiple diagnoses.
6. Click on the X to close the overlay and this information will now show under the Diagnoses field.
If you need to Update a diagnosis:
1. Select the Plus icon on the Diagnoses field.
2. Hover over the Actions column and select Update.
3. Make any changes required to the Status, When Diagnosed, Clinical Notes and Reported by Patient fields, and select Update.
If you need to Delete a diagnosis:
1. Select the Plus icon on the Diagnoses field.
2. Hover over the Actions column, and select Delete.
3. If you are sure you want to delete this diagnosis, select Delete.
