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Diagnosis List Ranking & Linking

It would be paramount to organization, flow and reimbursement if we could rank diagnoses in order of importance during each visit in the Assessment portion of the note, and then link diagnoses to procedure codes in the Plan of each note. Currently, I can rearrange the order of diagnoses, but it does not hold that order in Finalize or future notes. This is a quick and rudimentary method of justifying in each note, why each procedure was performed or how each diagnosis was addressed, without additional sentences or explanations that create clutter in a note.

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Dr Cassandra Baar shared this idea  ·   ·  Admin →
Acknowledged  ·  Matthew Douglass responded  · 

This is a solid idea. We’re currently digging into how our current Problem List works and this is valuable input for how we may shape this feature.

How else would you like to see the Problem List evolve and improve?

19 comments

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  • CMK commented  · 

    This is a critical and urgent feature and is urgently needed. Please move it up the list.

  • Dr Adrienne Classen commented  · 

    Most of my patients are complex, sometimes with 12 + dx. It would be great to be able to organize the diagnoses into an order that made sense and was easier to chart. Drag and drop would be ideal..

  • Anonymous commented  · 

    Once diagnosis order is changed, I would like to have it available in that new order for future visits so I don't have to reorganize Dx each visit.

  • Karen Adams commented  · 

    Please organize chronic diagnosis in the patient chart-not just during the encounter via assessments. For example Hyperlipidemia with Coronary artery disease. This would make patient charts more intelligible for someone's else reading.

  • William Gilmer commented  · 

    agree, need to rank order dx by importance at each visit, and keep that order for use at next visit. Also agree completely with Dr Casals comments. Perhaps in A and P, should offer each dx code, be able to click on each dx and beneath add comments, update assessment , and add plan/orders under to each dx.

  • Dr Dipti Patel commented  · 

    With icd 10 , the option of adding multiple diagnosis ,one after other is gone.please bring that back .Very helpful for our geriatric population
    To" add another "we either have to click done then start with + sign, or under assessments add oen at a time

  • Dr Mary Casals commented  · 

    1. Would also request that we have the ability to choose a diagnosis code from the problem list . I agree that lab and imaging should be linked to diagnosis codes specific to the patient.
    2. Need to be able to click "collect from lab" one time for one batch of labs instead of multiple times for each lab that is ordered on the same date. At present there are too many clicks before we can successfully order a lab.
    3. Need fasting or non-fasting options
    4. Need other options of when to have labs done: today, prn, 1-2 weeks before next visit
    5. Need to be able to see medication list, current progress note and past/future appointment dates when ordering labs or imaging.
    6. Need to have the option to print an order slip for the patient to bring to the lab or imaging center even after we've transmitted their orders . Many times patients (especially diabetics) are advised to return every 3 months and instructed to have lab drawn 1-2 wks prior to the next visit. It easily gets forgotten if there is no paper trail. Our elderly patients do not have email.
    7. Just need better organization overall. The program requires too many clicks to get a job done even for an office that's been using an EMR for the past 14 years. There's also too much movement from one tab to another.

  • Glaucoma Doc commented  · 

    Agree that diagnoses should be "orderable" and keep the order.

  • Dr Robert Delapenha commented  · 

    Have the system identify and flag or alert when duplicate diagnoses are being listed. Also diagnosis codes with a period after it (without any other numbers following the period)should be removed from the system as possible choices. eg 042 and 042. are both listed in the system for a diagnosis of AIDS. Listing both serves no purpose that I am aware of other than to cause confusion on the part of the person selecting. The code with the period at the end is also not compatible with the billing system, and must be removed before the bills can be completed and sent.

  • Dr Marc Tanenbaum commented  · 

    My preference for the problem list is to use it in the same manner as I did with a written problem list: List the problem only once, BUT include dates of occurrence and resolution out to the side. This way patterns are more readily noted. An ever expanding list of repeated problems (Gastroenteritis, otitis media, sinusitis, colds) simply leads to clutter and pattern disappearance.

  • Doctor B commented  · 

    Custom "priority list" makes sense as a display option for those who want it.
    But I like to sort the Dx's by ICD, to make sure there are no similar or duplicate Dx's, so I wish you would have that, too. When scanning a long list of Dx's, often my staff and I don't see that the Dx we're about to add is already there. So I hope you make ICD Sort available.
    Also, when there is a duplicate Dx, I can't delete one if both have been in chart notes or medications. I would like to be able to cut/paste the info, meds, comments, etc. from one into the other and then delete the emptied Dx and keep the merged one. I think others have suggested various "merge" needs as well.
    Same function would help when the diagnosis listed is not the one that has HCC/RAF value, and I have to add the better scored ICD, I'd like to merge then delete the old one.
    Same with medications that have duplicates because the refill request system adds the medication as if it were new, instead of listing the refill under the existing medication, so the list is cluttered up with several lines for the same Rx.

  • DG commented  · 

    reordering in "Chronic Active" area and STAYING in that order allows for us to hit the "ADD ALL ACTIVE" button in charting. Then we dont need to reorder every chart note for billing.

  • Doctor B commented  · 

    The general idea of saving the diagnosis list in the order we want is a very necessary function. For me, listing by ICD code is my preference. The main requirement is not to lose the desired order every time the chart is closed.

  • DG commented  · 

    The coding is already in place (on the chart note). The code just needs to be moved to the "Active Area" of "Diagnosis". Then it needs to remember the order we put it in! This is VERY important when billing Insurance companies.

  • Dr Susan Scharf commented  · 

    I agree with Steve Spoolmanpt that it would be nice if the dx codes and the treatment/ procedure codes would automatically transfer from the chart note to the dx list and Super bill

  • Randall commented  · 

    I would like to see the diagnosis list populated in order of most used rather than by number.

  • Steve Spoolmanpt commented  · 

    I think this is a good idea, It would also be nice if the dx codes and the treatment/ procedure codes would automatically transfer from the chart note to the dx list and Super bill, as a physical therapist we need to document dx codes in the assessment, but also need to put the CPT codes in the objective portion of the note.

  • Ariel commented  · 

    It would really help my billing company if I could order the diagnoses.

  • ariel commented  · 

    I'd like to be able to separate it into two sections: ones I manage and ones another provider manages.

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