Problems Section

1. In the patient chart, click the Problems tab on the left side of the page.
2. Click a problem name to view it and add an onset date and notes.
3. Click the flowsheet icon to view the flowsheet and related diagnosis notes.
4. Click HISTORICAL to view historical problems. You can toggle between HISTORICAL and ACTIVE.

1. In the patient chart, click the Problems tab on the left side of the page.
2. Click the plus icon .
3. Begin typing the problem into the search field and select the problem from the search results.
   Note: You can enter SNOMED-CT problems that are not mapped to ICD‑10 codes, as well as problems that have associated ICD‑10 codes.
4. Status — Select Active or Historical to add this problem to the current list or to the Historical Problems list.
5. Type — Select Acute or Chronic.
6. Laterality — Select the laterality: Left, Right, or Bilateral.
   This field appears only when you select a SNOMED-backed procedure that requires laterality.
7. Onset date — The default value is today's date, but you can edit the onset date.
8. Last occurrence — Select the last occurrence date.
   Note: This field appears for historical problems only.
9. Removal reason — Enter the reason the problem can be removed from the patient chart.
   Note: This field appears for historical problems only.
10. To add a note about the problem, click the note icon , then enter the note.
11. Click Add.

1. In the patient chart, click the Problems tab.
2. Click the problem you want to move.
3. Click Historical.
4. Last occurrence — Today's date appears by default, but you can enter a different date in this field.
   
   The date must be between the onset date and today's date.
5. Removal reason — Enter the reason for stopping the problem.
   Note: If you are deleting a problem that was added in error, select the Delete (added in error) option.
   The problem is moved to the Historical Problems list.

1. In the patient chart, click the Problems tab on the left side of the page.
2. Review and familiarize yourself with the patient's current problem list.
3. Click the name of the problem that you want to stop or delete.
4. Click the delete icon .
5. Click Delete Problem.
   

 

Tip: Administrators can set this preference at the practice level so the same preference is applied to all users. See To update practice-wide user preferences.

1. Display the User Preferences page: On the Main Menu, click Settings > User Preferences.
2. Select the Automatically accelerate A&P diagnoses to Problem List option.
3. Click Submit.

 

The Care Episodes & Tracking section of the Problems tab provides access to the cardiovascular risk and pap smear flowsheets (if you used the pap smear flowsheet in the Classic version of athenaClinicals). If your practice uses the Physical Therapy episode feature, these episodes are also available in the Care Episodes & Tracking section of the Problems tab.

1. In the patient chart, click the Problems tab, and then scroll down to the Care Episodes & Tracking section.
   
   Open episodes are listed under the Care Episodes & Tracking heading.
2. To view and edit an existing care episode, click the flowsheet icon to open the flowsheet.
   
   
3. Review the available header fields (for example, Smoking Status) and add any relevant information. If information already appears in the field, you can hover over it and click the header section to expand it and edit values.
4. The Table view contains a list of relevant measures and analytes. Click a date to update or edit the values.
   Note: You cannot edit values that were entered during an encounter.
5. To add a care episode, click the plus icon and select cardiovascular risk.
   athenaOne adds the flowsheet to the Care Episodes & Tracking section.
   Note: If the pap smear or physical therapy option appears when you click the plus icon , you can add these items to the Care Episodes & Tracking section.

1. In the patient chart, click the Problems tab on the left side of the page.
2. Click the problem that you want to add to the Pregnancy Problem List section to display the details.
3. Select the Add to pregnancy problem list option.
   The problem is now listed in the Problems section and the Pregnancy Problems section of the Problems tab, as well as in the Pregnancy Problem List section of the OB episode.
   Updates to the problem are applied to all lists automatically.
   
   Note: You can check the box in the Hide column of the Pregnancy Problem List section of the OB episode to hide the problem on the Pregnancy Problem List.

1. Open the OB episode.
2. Check the box in the Add to Patient Problem List column and click Save.
   
   "Added" now appears in the Add to Patient Problem List column. The problem appears in the Pregnancy Problems section of the patient chart and is automatically synchronized with the OB episode.

 

In the patient chart, click the Problems tab on the left side of the page. The Patient Risk score or x Diagnosis Gaps appears at the top of the list. Click this link to view the Patient Risk dashboard.

 

 

Tip: Administrators can set this preference at the practice level so the same preference is applied to all users. See To update practice-wide user preferences.

1. Display the User Preferences page: On the Main Menu, click Settings > User Preferences.
2. Select the Show patient risk score instead of potential diagnosis count in Problem List option.
   
3. Click Submit.

 

You can display ICD‑10 codes in the Problems list to see the codes associated with each diagnosis from the most recent encounter or order group.

Note: Before athenaOne can display the associated ICD‑10 codes in the Problems list, an encounter must be closed, and an order group must be signed. For more information, see ICD‑10 codes in the Problems section.

1. In the patient chart, click the Problems tab on the left side of the page.
2. Click Settings and select Show ICD‑10 Codes.
   Note: The next time you open the Problems tab in any patient chart, athenaOne displays the ICD‑10 codes.
   
3. To hide ICD‑10 codes in the Problems list, click Settings and clear the Show ICD‑10 Codes option.
   

 

athenaOne displays the ICD‑10 codes associated with each diagnosis from the most recent closed encounter or signed order group. To see all ICD‑10 codes that providers in your practice have selected for a problem in the patient chart — not only the codes from the most recent encounter or order group — open the problem flowsheet.

1. In the patient chart, click the Problems tab on the left side of the page.
2. Click the flowsheet icon next to a problem to view the flowsheet and related diagnosis notes.
   
   
3. On the flowsheet, click Diagnosis History (X Visits) (X stands for the number of visits for this problem).
   
   The three most recent visits appear with any ICD‑10 codes selected for the visits.
   
   
4. If more than three visits are available on the flowsheet, click View all (x More) to display the earlier visits.

1. In the patient chart, click the Problems tab.
2. In the upper right of the Problems list, click Settings and under Sort select one of the following options:
   • Alphabetical — To sort the problems by name.
   • Last Modified — To sort the problems by modified date. If this option is selected, the most recently modified problems appear at the top of the ungrouped list or at the top of each group.
   • Custom — To rearrange problems in the Problems list when Chronic and Acute groupings are turned off.

1. In the patient chart, click the Problems tab.
2. Use one of the following methods to move the problem:
   
   
   • Click the problem you want to move and click the category you want to move it to (Chronic or Acute).
     
   • Drag and drop the problem to the category you want to move it to.
     

1. In the patient chart, click the Problems tab.
2. Click Move Multiple.
   
3. Select the check boxes next to the problems you want to move.
   
   Tip: To select all problems in the list, select the check box to the left of “Move x to.”
   
4. At the top of the Problems list, select the category to move the problems to (Chronic, Acute, or Historical).

You can turn off grouping in the Problems list so that problems are listed without the Chronic and Acute categories.

1. In the patient chart, click the Problems tab.
2. In the upper right of the Problems list, click Settings and select No Groups.
   

 

Yes, when a problem is categorized for a patient, the problem is saved under that category for all users that view that patient chart.

 

 

Yes, if you disable grouping within a patient chart, it applies to all patients in that context. However, it only applies to your view of that patient chart and does not impact other users. Your user settings for grouping, sorting, and showing ICD-10 codes are different in each context.

 

 

The Past Medical History portion of the History section is intended for documentation and review of the patient's medical history at the time of transfer of care into the practice or when patients update this information on the Patient Portal. You should document all active and historical medical problems in the Problems section.

 

 

Health concerns (referred to previously as "reasons for care") documented in the care plan are problems, barriers to care, or social determinants of health that patients should focus on with guidance and assistance from the patient's care team. You use the care plan to document goals and tasks for patients enrolled in care management (see athenaClinicals Care Plan or, for Population Health, User Guide: Care Plan).

 

Health concerns on the Care tab are associated with the patient. Not all problems documented on the Problems tab need to be addressed in the care plan as health concerns.

 

 

At the top of the Problems list, a link displays the number of potential diagnoses (x potential diagnoses) or No potential diagnoses by default. Click this link to view the Patient Risk dashboard.

 

Note: You can change your user preferences to set the patient risk score to show instead of the number of potential diagnoses at the top of the Problems list.

 

 

You can change your user preferences to have diagnoses automatically added to the Active Problems List when you add them to the Assessment and Plan section of an encounter. When diagnoses are automatically added to the Problems list, they are added under Not Categorized and are marked with a gray arrow .

 

Note: Diagnoses are automatically added to the Problems List only when an ICD-10 code is added to the diagnosis. Also, some diagnoses/ICD-10 codes that aren’t considered problems (such as “well child visit”) are not automatically added to the Problems List.

 

 

 

The Problems section of the patient chart displays the current ICD‑10 codes associated with each diagnosis from the patient's most recent encounter or order group when:

• The diagnoses were added on or after June 19, 2018.
• The associated encounter is closed or the associated order group has orders for the diagnoses and is signed.

Note: All ICD‑10 codes used in the most recent encounter or order group appear in the Problems section. If an ICD‑10 code is added outside an encounter or order group (for example, using the Add Document workflow), the code does not appear in the Problems list.

 

Diagnoses in the Historical Problems list include the ICD‑10 codes as long as the diagnoses were used in signed order groups or closed encounters on or after June 19, 2018.

 

Adding a problem from the Problems list to an open encounter or order group

If you add a problem from the Problems section of the chart to an open encounter or order group (by clicking the add to D&O icon ), the ICD‑10 codes shown in the Problems list are copied to the current encounter's Diagnosis and Orders cart. You should review the codes that were copied and edit them as needed.

 

Changing an ICD‑10 code in an order document that is signed and closed

If you reopen an order that was already signed and closed, you can change the ICD-10 codes.

• If the ICD‑10 code was used in only one order, the code is removed from the Problems list. If you then select a different ICD‑10 code and sign the order, the updated code appears in the Problems list.
• If the ICD‑10 code was used in more than one order, the code is removed from the Problems list for a diagnosis only if all orders under the diagnosis are unapproved. If you then select different ICD‑10 codes and sign the orders, the updated codes appear in the Problems list.

Changing an ICD‑10 code in a closed encounter

To change the ICD‑10 code in a closed encounter, you must amend the encounter and update the code associated with a diagnosis. The corrected code appears in the Problems list after you save the amendment.

 

In some cases, the encounter cannot be amended because it has become free text. In such cases, the ICD‑10 code in the Problems list cannot be updated until a newer code used in a newer encounter or order group replaces it. For more information, see To amend a closed encounter.

 

 

The Care Episodes & Tracking section of the Problems tab provides access to a number of flowsheets, including the cardiovascular risk and pap smear flowsheets (if you used the pap smear flowsheet in the Classic version of athenaClinicals).

 

 

 

Imaging results appear in the graph view of the flowsheet in the Problems section for the associated problem. For example, if you order a mammogram for a malignant neoplasm of breast diagnosis, the order automatically appears in the flowsheet for the malignant neoplasm of breast problem listed in the patient chart. You can also drag imaging results that are tied to certain clinical order types (for example, echocardiograms) from the Results chart tab to a flowsheet.

 

Note: If you use a global flowsheet that is configured to recognize any imaging result type (X-ray, CT, MRI, etc.), a result may appear even if the associated order does not include a diagnosis tied to that imaging result type.

 

 

If you previously used the Classic version of athenaClinicals, you may have entered notes in the header of a global flowsheet. You can no longer edit this information, but you can click the field to copy the information into another section of the chart, such as the problem's Note field, where the information can be edited, or you can delete the information permanently.