Problem List Overview

The Problems chart tab is where you review and manage a patient's problem list. The redesigned screen shows each problem as an easy-to-read card, keeps the most recent note in view, flags drug–disease interactions, and lets you add, edit, reorder, and deactivate problems quickly.

Screen layout

The screen has three main areas:

• Header bar — the screen title (Problems), the Import Queue button, a Refresh button, and a More (⋮) menu.
• Search bar — a search-type selector, the problem search box, and the Quick Add switch.
• Problem list — the Active and Inactive tabs, the Reorder and Notes controls, and the problem cards themselves.

Active and Inactive tabs

Problems are split across two tabs, each showing a count of how many it contains (for example, 4):

• Active — the patient's current problems (including those marked as a Recurrence or Relapse).
• Inactive — problems that are no longer current (Inactive, Resolved, Removed, or in Remission).

Reading a problem card

Each card shows the key information for one problem:

• Code — the problem's ICD code, shown before the description. An expired code is highlighted.
• Description — the problem name.
• Date — when the problem was added. Problems added today are highlighted and show the time.
• Verification badge — the current verification status (see below).
• Drug Interactions — when a problem interacts with the patient's medications, a warning appears; click Drug Interactions to expand the list of medications involved.
• Most recent note — when Notes are turned on, the latest note appears at the bottom of the card, with who wrote it and when.

Verification badges

The badge on each card shows how the problem has been verified. This information is present within interoperability data such as FHIR & CCDAs as required by the ONC.

Confirmed Unconfirmed Provisional Differential Refuted Entered-in-Error

What you can do from this screen

• Add a problem — search for a code and add it, either through the full window or with Quick Add. See Add a Problem.
• Edit a problem — click an active card to open it. See Edit a Problem.
• Deactivate or reactivate — move a problem between the Active and Inactive lists. See Deactivate & Reactivate a Problem.
• Reorder — drag problems into the order you want on the Active tab.
• Add notes — keep clinical notes with each problem and copy a prior note forward. See Problem Notes.
• Manage favorites — star the codes you use most for fast reuse. See User Favorites.
• Import Queue — review problems queued from elsewhere in the chart. See Import Queue.

Header buttons

• Import Queue — opens the queue of problems waiting to be reviewed. A red badge shows how many are waiting.
• Refresh — reloads the patient's problems from the server.
• More (⋮) menu:
  • Audit Log — opens a detailed history of changes to the patient's problems.
  • Print — generates a printable problem list report.

Add a Problem

You add a problem by searching for it and then either filling in the details or letting Quick Add add it instantly. This article covers searching, the two ways to add, and every field in the Add Problem window.

Step 1 — Choose how to search

Use the selector to the left of the search box to choose how you want to look up the problem:

• ICD Code — search by ICD code or description. This is the default value and expected to be used the most heavily.
• SNOMED (partial) — search SNOMED terms that match part of what you type.
• SNOMED (full) — search the full SNOMED term.

Step 2 — Search for the problem

1. Click in the Search by code or description box.
2. Begin typing a code or description. Matching results appear as you type, and more load as you scroll.
3. Your favorites appear first, marked with a star, so common problems are easy to grab. See User Favorites.
4. Click the result you want.

Step 3 — Add the problem

What happens after you select a result depends on the Quick Add switch:

• Quick Add off — the Add Problem window opens so you can review and complete the details before saving.
• Quick Add on — the problem is added to the bottom of the Active list immediately, and a confirmation message appears.

The Add Problem window

When the window opens, you can set the following. Required fields are marked with an asterisk (*).

Verify options

Unconfirmed Provisional Entered-in-Error Confirmed Refuted Differential

New problems start as Unconfirmed until you choose another status.

Save your own wording for a code

If you change the description so it differs from the standard wording for the code, an option appears: Default your description for code [code] to "…"? Check it to make your wording the default the next time that code is used.

Step 4 — Save

Click Save to add the problem, or Cancel to close without saving. Save is available once the required fields — Description, Status, and Onset — are filled in.

You can update any active problem on the patient's list. This article covers opening a problem,  changing its details, and reordering the list.

Open a problem for editing

On the Active tab, you can open the Edit Problem window in two ways:

• Click anywhere on the problem card.
• Click the pencil icon on the card.

What you can change

The Edit Problem window has the same fields as when adding — Description, ICD, SNOMED, Status, Type, Onset, Resolution, Verify, Chronic, and Note. See Add a Problem for a full description of each field.

When editing, two extra details are available:

• Resolution date — set when the problem was resolved.
• Last Modified — shows the date and time the problem was last changed.

The window also lists the problem's existing notes, so you can review, edit, or copy a previous note forward. See Problem Notes.

Save your changes

Click Save to keep your changes, or Cancel to close without saving. A confirmation message appears when the problem is saved.

Reorder the problem list

To change the order in which problems appear on the Active tab:

1. Click Reorder (above the list, to the right).
2. Drag each problem by its handle into the order you want. Notes are hidden while you reorder to keep the cards compact.
3. Click Done to save the new order.

Problems move between the Active and Inactive tabs rather than being deleted, so the patient's history stays intact. This article explains how to deactivate a current problem and how to bring an inactive problem back.

Deactivate a problem

Deactivating moves a problem from the Active tab to the Inactive tab.

1. On the Active tab, find the problem you want to deactivate.
2. Use the problem's deactivate action.
3. Confirm when prompted.

When you deactivate a problem, its Resolution date is automatically set to today and its status is updated so it no longer appears as current. The problem then shows on the Inactive tab.

Reactivate a problem

Reactivating moves a problem from the Inactive tab back to the Active tab.

1. Select the Inactive tab.
2. Find the problem you want to bring back.
3. Use the problem's reactivate action.
4. Confirm when prompted.

The problem returns to the Active tab. You can then open it to adjust its status, onset, or other details if needed.

Favorites let you keep the codes you use most at your fingertips. When you search to add a problem, your favorites are listed first, so common problems are one click away.

How favorites appear

When you open the problem search, your favorite codes are shown before any other results and are marked with a star. As you type, favorites that match stay sorted to the top of the results. See Add a Problem for the full search steps.

Add a favorite

1. Start a problem search and find the code you want.
2. Click the star icon next to that result.
3. The star fills in to show the code is now a favorite.

Remove a favorite

1. Find the code in the search results (favorites appear at the top).
2. Click the filled star icon to remove it from your favorites.

Notes let you keep the clinical context with each problem. You can add a note when you create or edit a problem, review a problem's earlier notes, and copy a previous note forward so you don't have to retype it. Depending on the customization of your SOAP/Progress Note templates, this note will display along with the diagnosis list.

Show or hide notes on the list

Use the Notes switch above the problem list to show or hide notes on the cards. When it's on, each problem card shows its most recent note at the bottom, along with who wrote it and when.

Add a note

You add or update a note from the Add Problem or Edit Problem window:

1. Open a problem (or start adding one).
2. Type your note in the Note box on the right side of the window.
3. Click Save.

Review earlier notes

When you edit a problem, the window lists the problem's existing notes beside the note box. Each entry shows the note text along with who entered it and when, so you can see how the problem has been documented over time.

Copy a note forward

To reuse an earlier note, click the copy icon on that note. Its text is copied into the note box so you can keep it as-is or adjust it before saving. Use the edit icon to change an existing note.

Problems can be sent to the problem list from other parts of the chart. The primary source for these items are selections made within encounter templates that are pushing a Template Action. Those problems wait in the Import Queue until you review them and decide which to add.

Opening the Import Queue

The Import Queue button is in the header bar at the top of the Problems screen. When items are waiting, a red badge shows how many. Click the button to open the queue.

Reviewing queued problems

The queue lists each waiting problem with:

• Description — the problem name.
• Location — where in the chart the problem came from.
• Created — when it was added to the queue.

Adding or removing problems

• Check the problems you want, then use Add All to bring the selected problems onto the list.
• Use Remove All to clear the selected problems from the queue without adding them.
• Click OK to apply your choices, or Cancel to close without changes.