The Problem List and SOAPs section allows you to add in episode problems, which can then be linked to the patient's master problem list. It also allows you to complete a SOAP for each identified episode problem(s).
For this course you are only required to complete one Subjective and Objective for each day. However, every problem will need their individualized Assessment and Plan.
Episode Problems
From the Patient Record Visit Information tab, click on Add Problem to open up the Episode Problem list.
You may select from the drop down list or if your problem is not present you may enter a new one via free text.
Creating SOAPs
Once you have added Episode Problems you can begin to SOAP the problem(s).
Hover over today’s date and add the Subjective and Objective, at the day level.
Once you enter your text for each section, save your work by clicking the green check in the header section.
After saving your daily Subjective and Objective you can begin your Assessment and Plan for each problem.
Hover over each problem to add you’re A & P.
A completed SOAP may look like the below record.
Merging Problems
If multiple problems have been identified to be related (e.g. symptoms of the same underlying disease) you can Merge the problems within the episode.
First, add your newly identified Problem.
Then, hover over the previous Problem you are wanting to roll into your newly identified problem. Click the merge icon.
You will be able to select your new Problem from a drop down list and the previous problem will be merged in to the selected Problem.
Click the tiny green check mark to save your merge.
You can repeat this for multiple problems if necessary.
Your Problem section will now display like the below. Note: If you have not entered a SOAP information for the old merged problem, they will be removed from the Patient Record when the screen refreshes. If SOAP information is entered, they will stay displayed with the (Merged To: XXXX) comment.
Renaming Problems
If a Problem has been inappropriately named, you can hover over the Problem and select Rename Problem. Note: It is not advised to rename a previously merged problem. This is not an intended workflow and has unpredictable behavior in version 1.6.10. The VetView development team is researching this workflow for possible improvements.
Side Notes
If you incorrectly add or cancel a SOAP, do not worry. System hiccups will not affect your grade. If possible, make a comment “added in error” etc., and re-add the section (inactivate if a problem was added in error) and continue with your medical record.
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