Allergies
This lesson will demonstrate how to document in the Summary Allergies field.
Summary Allergies Field
The Allergy field in the Summary is used to maintain an active allergy list for the patient.
New SMARText Type: Allergy
SOAPware contains a SMARText Item type for Allergy items (see Type column in the screenshot above).
Placing of the Insertion Point
With a patient chart open and the Summary chart section visible:
- Place the insertion point to the right of the field header.
- Click to insert the cursor.
If the bold green brackets appear (as shown above), then the field is active and OK to begin entering data.
Documenting "No Known Drug Allergies" in SMARText
When a patient has no known drug 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. For instructions on re-downloading this item, please see: Using No Known SMARText Item Types in the Summary.
Entering an Drug Allergy using Keywords
To search for a SMARText allergy/intolerance item by using a keyword, type the keyword into the Allergies field (ex: "penicillin") and then press Shift + F11 on the keyboard to view the search results. The Shift + F11 search will allow the user to view list of allergy items that are located on the local library AND on the SOAPware Cloud Library. An F11 search may also be used to view only a list of SMARText items that are on the local library.
Double-click on the desired SMARText Item to enter it into the patient's Allergies field.
Regarding keywords:
- A SMARText item can have an unlimited number of keywords.
- No SMARText item has every possible keyword that users prefer.
- Users can add keywords to meet their preferences.
- The longer the keyword (i.e. typed entry to search), the faster the search.
Completing the Allergy Sub-Items
The new SMARText Allergy Items contain sub-items that can be completed for the allergy. These include the following:
- Severity
- Reaction
- Status
- Type
- Onset
Click on any of the sub-items to select the appropriate response from the SMARText Quick Access window.
Allergy Items for Medications & Medication Categories
Individual medication allergy items and allergy item categories are now available in SMARText. For example, if you do a Shift + F11 search for Amoxicillin, the search will reveal both the Allergy item for Amoxicillin and the Allergy item for its category of Penicillins.
Using Rx SMARText Items in the Allergies Field
Any Rx SMARText item may also be used within the Summary Allergies field to record a medication allergy.
Entering Non-Drug Related Allergies
SMARText items are only available for medication 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).