Allergies

This lesson will demonstrate how to insert the Allergy Starter Pick List if the Summary docuplate does not already contain the Starter Pick List.  This lesson will also describe how to use the Allergy Starter Pick List and how to insert Allergies that are not drug related allergies.

The Allergy field in the Summary chart section is used to record a list of the patients allergies and intolerance.  This list is used when ePrescribing to alert the physician of any possible allergy to drug interactions.

*REQUIRED FOR MEANINGFUL USE

- Medication Allergy List

- Drug Interaction Checks

Patient Meaningful Use Dashboard:

This requirement will be tracked via the Patient Meaningful Use Dashboard

Placing of the Insertion Point

Placing of the Insertion Point

With a patient chart open and the Summary chart section visible:

1.  Place the insertion point to the right of the field header.

2.  Left-click the mouse to insert the cursor.

If the bold green brackets appear (as shown above), then the field is active and ok to begin entering data.

Using No Known SMARText Item Types

Using No Known SMARText Item Types

When a patient has no known allergies, documentation must be entered as structured data by using the SMARText Item for "Drug Allergies: No Known".

Type "nkda" into the Allergies field and Press the space bar. This will expand into the structured data required for this field.

*Note: Users will need to re-download the "nkda" SMARText Item for use within SOAPware 2011.  For instructions on re-downloading this item, please see: Using No Known SMARText Item Types in the Summary.

Inserting the Starter Pick List for Allergies

Inserting the Starter Pick List for Allergies

To insert the Starter Pick List for Allergies:

1.  Type all- into the Allergies field (as shown above).

2.  Press the spacebar to expand the Pick List.

Note: If the Pick List does not expand when  the Spacebar is pressed, the user may need to do a Shift + F11 search to download the item to the local database.  Once the user has used the Pick List once, the user will be able to expand it using the Spacebar method.

Allergies Starter Pick List

Allergies Starter Pick List

The allergies Starter Pick List is used to record a list of the patients allergies and intolerances.  This list is used when ePrescribing to alert the physician of any possible allergy to drug interactions.

Accessing the Allergy Starter Pick List

In SOAPware, text that appears Blue and Underlined indicates that a Pick List is attached to the SMARText item.

Left click on the Pick List header (ie: Starter - Allergies - Summary) and a list of items will appear in the SMARText Quick Access Dialog.

Choosing Items from the Allergy Pick List

Choosing Items from the Allergy Pick List

With the Allergy Pick List displayed in the SMARText Quick Access dialog, Click to place a check in the box in the "Select" field next to each of the items desired, to insert into the Allergy field.

When the items are inserted, the Allergy Pick List header will disappear.

The Allergy Pick List only contains drug related allergies.  To enter non-drug related allergies, such as food intolerance, see the step titled Entering Non-Drug Related Allergies below.

Attaching Item Comments to Allergies

Attaching Item Comments to Allergies

To attach a free text comment to the SMARText item:

1.  Left-click on top of the SMARText item (ie: Codeine - see above).

2.  Begin typing desired comments (ie: Nausea - as shown above).  An "Item Comment" box will appear for the user to type in.

Click Save.

The item comment will be inserted next to the SMARText item (see Codeine example above).

Entering Non-Drug Related Allergies

Entering Non-Drug Related Allergies

The Allergy Pick List only contains SMARText items for drug related allergies.  As a result, there will be a need to add non-drug related allergies such as food intolerance, in a free text fashion.  To enter free text non-drug related allergies, simply free-text type the intolerance into the allergy field (as shown above).

Adding SMARText Code to Non-Drug Related Allergies

Adding SMARText Code to Non-Drug Related Allergies

After adding the free-text non-drug related allergy, we suggest that a user add a SMARText code so the system won't recognize it as a drug interaction when performing the ePrescribing function.  

The SMARText item that the user will want to attach enters the text (ID-Ignore) next to the free-text allergy.  This will allow the sentence or line of text to be ignored in the drug interaction check.  If the user do not enter this SMARText item next to a free-text allergy the system will see the item as uncoded and will alert the user that there is an item it doesn't recognize, when the user is ePrescribing.

To insert the (ID-Ignore) SMARText item:

1.  Type the shortcut code id- next to the free-text allergy.

2.  Press the spacebar key on the keyboard to expand the SMARText item to read (ID-Ignore).