The HPI SMARText item shown in the screen shot above is compatible with EM coder.  The shortcut for the SOAPware created HPI item is HPIx.  This item contains multiple SMARText items with various item types.  Each item must be created with the proper item type and correct hierarchy, or this item will not calculate with EM coder, or operate correctly, when inserted into the patient's chart.

The HPI SMARText item is similar to a branching tree.  The main HPI header is the trunk of the tree.  The Symptoms Related, Location, Qualilty/Course, are the branches and the Reports/Denies are the limbs.  And finally, the Symptoms are to be considered the leaves.  

The HPI hierarchy is built backwards, meaning that a user would begin with building the lowest item (the leaves/Symptoms) and work backwards.

Here is a generic list of the steps of creating a custom HPI SMARText item:

1. Create or search for the symptoms.
2. Place symptoms into clusters (this may be a general cluster or body system specific cluster.  Many users create one generic cluster for each HPI Finding item).
3. Place those clusters into multi-sel lists.
4. Place multi-sel lists into the appropriate HPI Finding item: Symptoms/Related, Location, Quality/Course, Intensivity/Severity, Duration, Onset/timing, Context/When and Modifiers/Treatments.
5. Place all of the HPI Finding items inside an HPI SMARText item.

The first step to creating an HPI item is to locate symptoms on the SOAPware Cloud library, or create these symptoms individually.  Symptoms will have an item type of Structured Text.

SOAPware advises using SOAPware-created items when possible, as these contain SNOMED-CT, IPIC and SWIPIC codes in the background.

Should a user need to create his or her own symptom, please refer to Step 1 in the Creating Toggles lesson.

Open the SMARText Items Manger by pressing F10 on the keyboard (or select  Docutainers > SMARText Items from the menu bar)

1. Click on the Green + to create a new item.
2. In the SMARText Type Selection box, Select Custom.
3. From the drop down menu, click the expander node next to Generic as well as Lists, then choose Item Cluster.

Click the Create button.

Structured items will then be added to a Cluster in the Items Setting box within SMARText Designer.  The screen shot above shows structured respiratory symptoms that have been placed in a "Lungs" cluster.   It is not necessary to create a unique cluster for each body system, as many users simply create one generic cluster to be placed in the items under each HPI Finding item.

For information on how to create a cluster, see Step 2 of the lesson, Creating Toggles or review the lesson, Create Item Clusters and Bundles.

*Note: This step will be need to be repeated as necessary, to create clusters for each HPI Finding.

A Multi- Sel list is designed to allow the user to have the same choices in each list and select from multiple lists at all at once within SMARText Quick Access window-as shown above.  

After the cluster has been created, Multi-Sel lists for  Reports and Denies must be created.  If the user would like to use the toggle feature (+++++), known as SMARTips,  this would be the time to create this feature. To learn how to create a Multi-Sel List, please start at Step 3 on the Creating Toggles lesson.

The image above shows that when a user clicks on either Reports symptoms of, Denies symptoms. or SMARTips (+++++) the same list of symptoms will appear.

*Note:  If an item is selected under Reports it cannot be selected under Denies as well.

Open the SMARText Items Manger by pressing F10 on the keyboard (or select Docutainers > SMARText Items from the menu bar).

1. Click on the Green + to create a new item.
2. In the SMARText Type Selection box select Custom, click on the expander nodes (+) next to Generic and Lists, then choose  Multi-Sel List.

Click Create.

The cluster of symptoms/choices will be placed within each of the multi-sel lists: Symptoms include, Denies Symptoms or  SMARTips(+++++).   Basically the same cluster has been placed within each of these separate Multi-Sel lists.

1. Complete the Description, Keywords (remember to include a unique keyword for easy retrieval purposes) and Display Header for the list.  *Note:  It is not necessary to create a shortcut as this list will be placed inside of another SMARText item.
2. Drag and drop the Cluster into the Items Settings box, from the SMARText Items Manager.
3. Click Save.

Repeat this process for each of the 3 lists, for all HPI Finding items:

• Reports symptoms of
• Denies Symptoms of
• +++++

Open the SMARText Items Manger by pressing F10 on the keyboard (or select Docutainers > SMARText Items from the menu bar).

1. Click on the Green + to create a new item.
2. In the SMARText Type Selection box select Custom, click on the expander nodes (+) next to Generic, Subjective Items, and HPI Findings then choose the desired HPI Finding which in this case is Symptoms/Related.

Click Create.

1. Complete the Shortcut, Description, Keywords and Display Header for the list.
2. Drag and drop the Multi-Sel lists for Reports, Denies and SMARTips (+++++), in the Items Settings box from the SMARText Items Manager.  Also indicate in the Item Properties area to have Separate Lines.
3. Click Save.

Repeat this process for all of the following Multi-Sel lists if desired:

• Context/When
• Duration
• Intensivity/Severity
• Location
• Modifiers/Treatments
• Quality Course
• Symptoms/Related

Open the SMARText Items Manger by pressing F10 on the keyboard (or select Docutainers > SMARText Items from the menu bar).

1. Click on the Green + to create a new item.
2. In the SMARText Type Selection box select Custom, click on the expander nodes (+) next to Generic, Subjective Items, and HPI .
3. Select HPI Item.

Click Create.

1. Complete the Shortcut, Description, Keywords and Display Header for the list.
2. Drag and drop the HPI Finding items in the Items Settings box from the SMARText Items Manager.  Also indicate in the Item Properties area to have Separate Lines.
3. Click Save.

The HPI item is now complete and may be inserted to the patient's chart or desired docuplate.