3. Maintain Problem List

This lesson will demonstrate the steps necessary to meet the Meaningful Use Core requirement for maintaining an up-to-date problem list of current and active diagnoses.


SOAPware 2011 or later must be used.

Note: To determine the version of SOAPware being used, Click on Help > About SOAPware. This will open a window which will show the version and build of SOAPware currently in use.


This requirement will be tracked in the MU Patient Dashboard and the Meaningful Use Dashboard.

Measure Criteria

Objective:  Maintain an up-to-date problem list of current and active diagnoses.

Measure:  More than 80% of all unique patients seen by the eligible provider must have at least one entry or an indication that no problems are known for the patient recorded as structured data.

For more detailed information on this measure, please click on the "Reference" link below. This CMS documentation includes information on exclusions, attestation requirements, a definition of terms and important additional information.


Reference CMS: Maintain Problem List

Measure Calculation

Denominator: The number of unique patients seen by the provider that have a face-to-face encounter during the reporting period.

*Note: The denominator is unique patients rather than unique patient visits during the reporting period. Therefore, if a patient is seen three times in the reporting period, you only have to fulfill the rule once for that patient, rather than at all 3 encounters.   However, the patient must have at least one face-to-face encounter during the reporting period in order to fulfill the rule.

Numerator: The number of patients in the denominator who have at least one structured diagnosis item within the Summary Active Problems field (or an indication that the patient has no active problems).

Threshold: The resulting percentage must be more than 80%.

*Scoring is individual, provider-based and not practice-wide.

Maintaining the Active Problems List

Using structured diagnosis items in the Summary Active Problems field is required to meet this Meaningful Use measure.  This will involve using one of the SMARText data entry methods.

SMARText structured documentation can be entered using the following methods:

  1. Inserting Items with SMARText Items Manager
  2. Shift + F11 Search
  3. Shortcut Code/Macro
  4. F11 Search
  5. Starter - Active Problems Pick List
  6. Quick Access Location Pick List/Favorites List

Please see: Active Problems Documentation and SMARText Data Entry Methods for further instructions.


Indication that No Problems are Known

If the patient has no active problems, the structured item for No Problems should be inserted into the Summary Active Problems field. The shortcut for this item is "nopro".

*Instructions to Update/Redownload "nopro":

Earlier versions of SOAPware had a similar "No problems" structured text item.  In SOAPware 2011 & 2012, this item will need to be re-downloaded or updated so that it contains the proper coding in the background to calculate towards the meaningful use statistics.  To re-download this item from the SOAPware Cloud Library follow the steps below:

Click on Docutainers > SMARText Items.  

1.  Search for "nopro" (make sure to check the Include Cloud Library Items box), and click the Search (magnifying glass) button.

2.  Select the green downward facing arrow for the "No problems" with an item Type of "No Known Items" (see screenshot above).

3.  Click the blue Download button.

*Note: You may receive the following pop-up: "The SMARText item you are attempting to download already exists.  Do you want to overwrite it?".  Click Yes.


MU Patient Dashboard

This measure is tracked in the MU Patient Dashboard under "Problem List".  The Patient Dashboard can be viewed by selecting View > MU Patient Dashboard.

Once a diagnosis (or the indicate of No Problems) has been recorded in the Summary Active Problems field, the MU Patient Dashboard icon will change to a green check mark.  

*Note: The MU Patient Dashboard will be grayed out if there are no SOAPnote encounters.  It will also remain grayed out if the active SOAPnote encounter is signed off or if the SOAPnote encounter is a Non Face-to-Face encounter.

Meaningful Use Dashboard

This measure is tracked in the Meaningful Use Dashboard under "Problem List".  The Meaningful Use Dashboard can be accessed by selecting SOAPware > Meaningful Use Dashboard.

The Meaningful Use Dashboard will display the Numerator, Denominator and percentage for this measure, as well as, graph the Trend for the dates selected.

*Note: The dashboard icon will display a gray X if the threshold for this measure has not been met for the selected reporting period.  The icon will change to a green check mark once the threshold for the meaningful use measure has been met.